Join The Practice

We welcome new patients who live within our practice area to register with us.

Anyone in England can register with a GP surgery. It's free to register. You do not need proof of address or immigration status, ID or an NHS number.

GP surgeries are usually the first contact if you have a health problem. They can treat many conditions and give health advice. They can also refer you to other NHS services. You do not need proof of ID to register with a GP, but it might help if you have one or more of the following:

Passport | Birth certificate | HC2 certificate | Rough sleepers' identity badge | Hostel or Accommodation registration | Mail forwarding letter

If you're homeless, you can give a temporary address, such as a friend's address, a day centre or the GP surgery address.

Please note: You will be asked to upload the ID proof in case you request online access to medical records.


To register online please ensure that you complete all fields on both the new patient registration form and the health questionnaire that follows once you click ‘submit’.

Please ensure to fill in your Previous address on GP so we are able to trace your medical records.

Registrations will be processed within 2-3 working days.

 

Patient's details
If you know your NHS Number, please provide it
Day / Month / Year
Please help us trace your previous medical records by providing the following information
If you are from abroad
DD/MM/YYYY
Are aged 16 – 35 years, entered the UK within the last 5 years, have never been screened or treated for TB in the UK, were either born in a country with a high risk of TB or have spent more than 6 months in one of the high risk countries within the last five years. If this does apply to you, please book an appointment for a blood test.
Health Check

Dr Vino will be your allocated GP.

Ethnicity
Carers
Marital/ Relationship status
A summary care record (SCR) is an electronic record containing key health information, which can be made available to NHS healthcare staff caring for you in an emergency or when your GP practice is closed.
Preferred Chemist/ Nominated pharmacy for you prescriptions to be sent to electronically
Lifestyle
Smoking
Alcohol Audit C

Alcohol Reference Chart

One unit of alcohol is equal to one of the following:

Half pint of regular beer,

lager or cider,

Half a small glass of wine,

1 single measure of spirits,

1 small glass of cherry,

1 small measure of aperitifs.

Family History

Have your parents, brothers or sisters suffered from any of the following medical conditions? *

For Coventry road practice privacy notices, please click on the 'our services' tab on our website and scroll down to 'how we use your information' to find out more.

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.