Register for Online Services
Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.
I wish to have access to the following online services (Please tick all that apply):

Terms and Conditions

  • I have read and understood the information leaflet provided by the practice
  • I will be responsible for the security of the information that I see or download
  • If I choose to share my information with anyone else, this is at my own risk
  • I will contact the practice as soon as possible if I suspect that my account has been
    accessed by someone without my agreement
  • If I see information in my record that is not about me or is inaccurate, I will contact the
    practice as soon as possible
  • I understand that it is my responsibility to keep my account secure by keeping my details confidential
  • I understand that I can terminate my account at any time by contacting the surgery, or change my log in details by re-registering and that this form will be kept on my electronic records
  • I understand that my registration will be revoked if I constantly miss or cancel appointments.
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