New Patient Registration (new)




Please complete our online form

Page {{ paginatorProps.current }} of {{ }} ({{ paginatorProps.percentage }}% completed)
Contact Details

Information we need to register you with the practice
Please note all fields marked with a * are mandatory for your registration

NHS Number

If you have had a previous GP then you will find this on letters/prescriptions or at NHS - Find NHS Number.


It is your responsibility to keep us updated with any changes to your telephone number, email & postal address.

We may contact you with appointment details, test results, health campaigns or Patient Participation Group details.

For prescriptions
Other Details
Please bring details with you
Communication Needs



Learning Disability

Carer Details

Only add carer’s details if they give their consent to have these details stored on your medical record.

Medical History
Please include dates.
Family History
Drug Allergies and Food Allergies/Intolerances
Current Medication
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx

A medication review appointment may be needed.

Please note we can only issue medication after, we have verified your identity. To verify your identity please present your relevant documents in person to reception. It can take up to two weeks after this, for us to obtain your old notes, confirm and issue your medication.

Please ensure you have sufficient medication from your previous GP until such time.

Your Personal Alcohol Consumption

1 unit of alcohol is 218ml cider standard 4.5% ABV, 76ml Wine Standard 13% ABV, 25ml Whisky Standard 40% ABV, 250ml Beer Standard 4% ABV or 250ml Alcopop Standard 4% ABV

Audit Score Result

you have a score of 

If you are drinking less than 14 units of alcohol per week, then your drinking is within the UK Chief Medical Officers' low risk drinking guidelines.

But if you are drinking regularly at or above the low risk guidelines of 14 units a week, or, you are drinking six or more units - if you are female - or eight or more units - if you are male - in one single session (binge drinking), please consider the increased serious risks to your health being caused by your current drinking pattern.



Height, weight and BP

Please submit these values if you have them.

Work and home life

Adult Females

If needed, please book appointment.

Please use this date format: DD/MM/YYYY.

Students are at risk of certain infections including mumps, meningitis and sexually transmitted infections, as well as mental health issues including stress, anxiety and depression.

Please see the student health section on the NHS website.

Health Checks

NHS health check

If you are between the ages of 40 and 74 years and have not had a health check in the last 5 years, once you have registered, please contact reception who can book you in for a free check. This includes a free blood pressure, cholesterol and diabetes check as well as lifestyle advice.

Sexual health check

We offer free chlamydia/gonorrhoea/HIV checks as well as hepatitis and TB screening. Please register and then book an appointment with one of our practice nurses.

Further Details

Electronic Prescribing

Patient Participation Group

We are committed to improving the services we provide. The Patient Participation Group is a mechanism for us to gain valuable feedback from our patients about their experiences, views and ideas for improving our services.

Blood and Organ Donation

You will automatically be considered that you agree to become an organ donor when you die unless you are under 18, have opted out or are in an excluded group.

For further information, please see NHS - Organ Donation.

Your Health Record

Sharing Your Health Record

What is your health record?

Your health record contains all the clinical information about the care you receive.  When you need medical assistance it is essential that clinicians can securely access your health record. This allows them to have the necessary information about your medical background to help them identify the best way to help you. This information may include your medical history, medications and allergies.

Why is sharing important?

Health records about you can be held in various places, including your GP practice and any hospital where you have had treatment. Sharing your health record will ensure you receive the best possible care and treatment wherever you are and whenever you need it. Choosing not to share your health record could have an impact on the future care and treatment you receive. Below are some examples of how sharing your health record can benefit you:

  • Sharing your contact details: this will ensure you receive any medical appointments without delay
  • Sharing your medical history: this will ensure emergency services accurately assess you if needed
  • Sharing your medication list: this will ensure that you receive the most appropriate medication
  • Sharing your allergies: this will prevent you being given something to which you are allergic 
  • Sharing your test results: this will prevent further unnecessary tests being required

Is my health record secure?

Yes. There are safeguards in place to make sure only organisations you have authorised to view your records can do so. You can also request information regarding who has accessed your information from both within and outside of your surgery.

Can I decide who I share my health record with?

Yes. You decide who has access to your health record. For your health record to be shared between organisations that provide care to you, your consent must be gained.

Can I change my mind?

Yes. You can change your mind at any time about sharing your health record, please just let us know.

Can someone else consent on my behalf?

If you do not have capacity to consent and have a Lasting Power of Attorney, they may consent on your behalf. If you do not have a Lasting Power of Attorney, then a decision in best interests can be made by those caring for you.

What about parental responsibility?

If you have parental responsibility and your child is not able to make an informed decision for themselves, then you can make a decision about information sharing on behalf of your child. If your child is competent then this must be their decision.

What is your Summary Care Record?

Your Summary Care Record contains basic information including your contact details, NHS number, medications and allergies. This can be viewed by GP practices, Hospitals and the Emergency Services. If you do not want a Summary Care Record, please ask your GP practice for the appropriate opt out form. With your consent, additional information can be added to create an Enhanced Summary Care Record. This could include your care plans which will help ensure that you receive the appropriate care in the future.

How is my personal information protected?

Mile Oak Medical Centre will always protect your personal information. For further information about this, please see our Privacy Notice on our website or please speak to a member of our team

For further information about your health records, please see NHS - Your health records.

For further information about how the NHS uses your data for research & planning and to opt-out, please see NHS - Your data matters.

Summary Care Record

Summary Care Record (SCR)

The Summary Care Record (SCR) system is designed to help both your GP and any emergency staff you contact when the surgery is closed to treat your health needs more efficiently.

Your information will be shared between your GP practice, our local hospital and Out Of Hours service. This will enable your GP surgery to access results and any visits you have at the hospital quickly and efficiently, but it also means that if you have an emergency and contact the Out Of Hours service or visit A&E they will have access to your current medications as well as allergies and are better able to treat you.

Online Access to Your Health Record

Access to GP Online Services

Important Information – Please read before completing form below

If you wish to, you can now use the internet (via computer or mobile app) to book appointments with a GP, request repeat prescriptions for any medications you take regularly and look at your medical record online. You can also still use the telephone or call in to the surgery for any of these services as well.  It’s your choice.

It will be your responsibility to keep your login details and password safe and secure. If you know or suspect that your record has been accessed by someone that you have not agreed should see it, then you should change your password immediately. If you are unable to do this for some reason, we recommend that you contact the practice so that they can remove online access until you are able to reset your password.

If you print out any information from your record, it is also your responsibility to keep this secure. If you are at all worried about keeping printed copies safe, we recommend that you do not make copies at all. 

During the working day it is sometimes necessary for practice staff to input into your record, for example, to attach a document that has been received, or update your information.  Therefore you will notice admin/reception staff names alongside some of your medical information – this is quite normal.  

The definition of a full medical record is all the information that is held in a patient’s record; this includes letters, documents, and any free text which has been added by practice staff, usually the GP. The coded record is all the information that is in the record in coded form, such as diagnoses, signs and symptoms (such as coughing, headache etc.) but excludes letters, documents and free text.

Before you apply for online access to your record, there are some other things to consider. Although the chances of any of these things happening are very small, you will be asked that you have read and understood the following before you are given login details.

Forgotten history

There may be something you have forgotten about in your record that you might find upsetting.

Abnormal results or bad news

If your GP has given you access to test results or letters, you may see something that you find upsetting to you. This may occur before you have spoken to your doctor or while the surgery is closed and you cannot contact them.

Choosing to share your information with someone

It’s up to you whether or not you share your information with others – perhaps family members or carers. It’s your choice, but also your responsibility to keep the information safe and secure.


If you think you may be pressured into revealing details from your patient record to someone else against your will, it is best that you do not register for access at this time.

Misunderstood information

Your medical record is designed to be used by clinical professionals to ensure that you receive the best possible care. Some of the information within your medical record may be highly technical, written by specialists and not easily understood. If you require further clarification, please contact the surgery for a clearer explanation.

Incorrect information

If you think there is incorrect information contained in your medical record, please submit an admin eConsult outlining what the inaccuracy is and what you think the record should state.

Please tick all that apply
Patient Signature


You now need to attend the surgery with the documents detailed below within next 14 days. You will remain registered with your previous GP until this has been done. If you are homeless, a refugee or do not have the documents below for any other reason, please come into the surgery in person and discuss this with one of the reception team.

  • Photo Proof of ID e.g. Passport, Photo Driving License or Photo ID card
  • Proof of Address e.g. Bank statement, Utility Bill or Council Tax from within the last 6 months

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.


There appears to be a problem loading the form, please refresh the page.
If the error persists please contact us.