Register for Online Services

To register for our online services you will need to complete this form and then visit the practice, bringing  with you two forms of identification. One of these items should include your photograph.

We will then issue you a username and password.

Once you are registered you will be able to use the service to:

  • Order your repeat prescriptions
  • Make an appointment
  • Cancel an appointment
  • Change your contact details
  • Review your medications and known allergies


Before you apply for online access to your record, there are some other things to consider. Please view our Online Access Leaflet for more information.
Register for Online Services

Register for Online Services

I wish to have access to the following online services (please select all that apply):

If the patient is under 16, the parent/guardian must provide a valid Birth Certificate along with their photo ID.

I wish to access my medical record online and understand and agree with each statement: *
I consent to receiving reminders and information via:

Terms and Conditions

  • I understand that it is my responsibility to keep my account secure by keeping my details confidential
  • I understand that I can terminate my account at any time by contacting the surgery, or change my log in details by re-registering and that this form will be kept on my electronic records
  • I understand that my registration will be revoked if I constantly miss or cancel appointments.