Patient Registration

PLEASE DO NOT PREREGISTER UNTIL YOU HAVE SPOKEN TO SOMEONE AT THE PRACTICE AND CONFIRMED THAT YOU ARE ELIGIBLE

Patient registration forms are available here, which can be printed and completed, but patients must contact the

surgery as identity documents are needed

How to Register

Registration is quite a simple process. All the paperwork needed to register you as a new patient to the Practice is available below.

Please ensure that you have completed all of the following paperwork and brought with you to the Surgery with all necessary identification documents:

1. Completed HSC/R1 or HS200 Registration form (the form completed will depend on whether or not you are already registered with a GP practice within Northern Ireland).
2. New Patient Health Questionnaire
3. Proof of identity i.e. Passport or Driving Licence
4. If available, your current Medical Card

You have previously been registered in Northern Ireland and have a Health & Care number or transferring from a GP in Great Britain

If you have previously registered with a GP in Northern Ireland and have a Health & Care number (H&C no.) or you are transferring from a GP in England, Scotland or Wales; please complete the form called HS200.

Once completed, please bring this to the Surgery along with your Medical Card (if available), proof of identity and proof of address.

Access the HS200 form

Supporting documentation is required to register; please supply 1 item from each of the 2 categories.

List 1 (Lawfully in Northern Ireland):

• Vaild Passport
• Valid Visa issued by the UK Home Office
• Birth Certificate, and where applicable, Marriage or Civil Partnership Certificate
• Certificate of Naturalisation or proof of EEA status
• Other valid Photographic ID

List 2 (Residing in Northern Ireland):

• Current NI Driving Licence
• Current Northern Ireland Rates Bill
• Current Northern Ireland Electoral Identity Card
• Current Home insurance policy (valid for Northern Ireland)
• Signed, current Tenancy agreement (not hand written) or mortgage statement of a property in Northern Ireland
• Current Bank Statement for active accounts which show a Northern Ireland address
• Recently paid utility bill (gas, electricity or telephone NOT a mobile phone ) for a property in Northern Ireland
• Housing benefit award letter for a property in Northern Ireland

Registering for the 1st time or do not have a Health & Care number

If you are from outside of Northern Ireland and do not have a medical card you need to fill in an application form, which is called HSC/R1. This form is available in English and in a range of other languages. Please click on the link below to download the form in English.

Once completed, please bring this to the Surgery along with proof of address.

Access the HSC R1 form

Supporting documentation is required to register; please supply 1 item from each of the 2 categories detailed above AND 1 item from the following

List 3 (Reason for being in Northern Ireland):

• A letter of document form Department of Communities confirming receipt of a UK State pension
• A letter or document from the Department of Communities confirming receipt of Social Security Benefit
• Recent payslip from a current employer (showing employers address and employee's National Insurance number)
• Letter from HMRC with your Unique Tax Reference / Self Assessment return showing NI address
• S1 Form (not issued in the UK) or a letter from DSP confirming receipt of State Pension (ROI only)
• HMRC Tax Credit award

In addition to the registration form above, all patients are asked to complete a new patient health questionnaire.

Pre-registration

PLEASE DO NOT PREREGISTER UNTIL YOU HAVE SPOKEN TO SOMEONE AT THE PRACTICE AND CONFIRMED THAT YOU ARE ELIGIBLE

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 send to us. When you come to the surgery you will be asked to sign this form to confirm that the details are correct.

Online medical questionnaire for new patients

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.

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