Cliff House Medical Practice

01522 872872

Gresham Street – Branch Surgery

01522 872878

Pre Registration Form

GMS1 Style Registration Form

  • PLEASE ENSURE IF YOU ARE OVER 16 YOU ALSO COMPLETE THE HEALTH QUESTIONNAIRE.

    Please note that registrations will take up to 10 days to be processed. If you need urgent medical attention, please contact your current practice or 111.
  • Patient's details

  • DD slash MM slash YYYY
  • Please help us trace your previous medical records by providing the following information


  • If you are from abroad

  • We cannot complete your registration if you are from abroad and do not provide this date.

  • Were you ever registered with an Armed Forces GP

  • DD slash MM slash YYYY
  • MM slash DD slash YYYY
  • Footnote: These questions are optional and your answers will not affect your entitlement to register or receive services from the NHS but may improve access to some NHS priority and service charities services.
    Please tell your family you want to be an organ donor. If you do not want to be an organ donor, please visit www.organdonation.nhs.uk or call 0300 123 23 23 to register your decision.
    I would like to join the NHS Blood Donor Register as someone who may be contacted and would be prepared to donate blood.
  • All blood types are needed, especially O negative and B negative. Visit www.blood.co.uk or call 0300 123 23 23.
  • New patient health checks

    After you have registered with the practice, we will contact you to arrange a new patient health check. This is not an urgent appointment but helps us give you a smooth transition of care from your old GP Practice to ours. Thank you.
  • All over 16's MUST complete the health questionnaire also found on the website.

    Without this, we will be unable to register you. Thank you