New Patient Registration

keyboard_stethoscopeTo register please call at reception bringing your medical card, if available. To register with the practice you must reside within the practice area. Registration will only be completed once the Practice has received your forms and you have brought in 2 forms of ID

All new patients will be requested to complete a lifestyle questionnaire when applying to join the practice and we like all new patients to have a health check with a member of our clinical team within one month of applying and we cannot fully register you with the practice until this has been carried out. If you have a complex health issue you may need to see a Doctor.

You can, of course, see a Doctor if you have an urgent problem in the meantime.

Practice Area

WEST -  TO A56

Latchford, Wilderspool Causeway, Stockton Heath, Appleton, Appleton Thorn, Grappenhall, Grappenhall Heyes, Lower Stretton, Hatton, Higher Walton, Lower Walton, Moore, Daresbury, Thelwall 

If you are interested in registering with us please ask our receptionists for more detailed advice on our practice area.


Pre-registration with the practice

PreRegistrationIf you wish to pre-register click on the link below to open the form. When you have completed all of the details, click on the "Send" button to mail your form to us. You will still need to attend surgery to complete the process.  Please ensure that you fill all the form in, we will need the following:

  • Full name, including previous names
  • Date and place of birth
  • Last address
  • New address and post code
  • Last name and address of your previous Doctor
  • NHS number - it is not the same as your National Insurance number, you can find this on your prescription request slip.

Adult Registration Form

Child Registration Form

When you register you will also be asked to fill out a medical questionnaire. This is because it can take a considerable time for us to receive your medical records. There is an online version of this file too, which you may fill out and bring to the surgery. .When you come to the surgery you will be asked to sign this form to confirm that the details are correct.

Note that by sending the form you will be transmitting information about your self across the Internet and although every effort is made to keep this information secure, no guarantee can be offered in this respect.


We are trying to identify patients who are military veterans.  Did you serve for at least one day as either a Regular or Reservist in the British Armed Forces? Then please inform the practice either speak to our receptionist or email

Alternatively you may print off a registration form, fill it out and bring it in with you on your first visit to the practice.

New Patient Registration Questionnaire

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