Fast Track Registration

Telephone support

ALL TELEPHONE CALLS TO THE PRACTICE ARE RECORDED FOR MONITORING AND TRAINING PURPOSES.

As well as being available at the surgery, our medical staff are available to discuss your medical concerns over the telephone and in some cases may even be able to arrange for you to collect prescriptions from a near by pharmacy without having to visit the Practice.

You can register with Carepoint Practice if you live in North West London, Middlesex, Hertfordshire or Buckinghamshire and registering couldn’t be simpler.

IF YOU WANT A CONSULTATION AS SOON AS POSSIBLE AND TO REGISTER WITH THE PRACTICE, PLEASE COMPLETE THE FAST TRACK REGISTRATION FORM.

Completing this form online will fast track your new patient registration and allow you to request a same day consultation. Additional forms and health questionnaires may need to be completed when you first visit the practice. You will also be asked to provide proof of address in the form of a utility bill, rental agreement or bank statement.

Note. All fields marked * are mandatory and must be completed before the form can be submitted.

Patient Details (page 1 of 4)

Title *

Mrs

Miss

First Names *

Surname *

Previous surname/s

Gender *

Female

Male

Date of Birth (dd/mm/yyyy) *

Town and country of birth *

Home address *

Postcode *

Home Telephone Number *

Mobile Telephone Number

Work Telephone Number

Email address *

Ethnicity *

First language spoken *

NHS number if known

Smoking status *

Never smoked

Smoker

Ex-smoker