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Child New Patient Registration

Welcome to Kingswood Surgery and thank you for choosing to register with us.

In the section below you will find a purple (GMS1) form and a new patient questionnaire. Please complete both these forms as fully and as accurately as possible to enable us to complete your registration.

You will also find information and forms relating to opting out of the sharing of your data as well as forms to request access to your online record (this also enables you to book appointments and request repeat prescriptions online).

Please note that we require photographic identification for your registration and in particular before we can process any application for online access.

Please return all the appropriate forms (purple registration, questionnaire & online access) with your photographic identification as soon as possible.

If you have any queries regarding your registration, please do not hesitate to contact the surgery.

GMS1 Registration Form

New Patient Questionnaire under 16 (pdf, 133KB)

Application for Parental Access to Child's Online Services (pdf, 411KB)

Click here to complete an online registration form combining all three forms.

IDENTIFICATION DOCUMENTS REQUIRED WHEN REGISTERING AS A NEW PATIENT

When returning the completed registration form, please bring your proof of identification. We are unable to register you without this.

PROOF OF NAME

(One of the following)

  • Birth Certificate
  • Marriage Certificate
  • Driving Licence (valid)*
  • Passport (Valid)*

PROOF OF ADDRESS;MUST BE DATED WITHIN THE LAST 3 MONTHS

(One of the following)

  • Utility Bill
  • Council Rent Book
  • Bank Statement
  • Credit Card Statement
  • Letter from Benefits Agency

*Please note if applying for Online Access to your medical records, photo ID must be produced.

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