Personal information retained on this system is stored in a secure data centre located in the UK and is treated as confidential.

NHS GMS1 family doctor services registration form heading

  • Your details:

  • Please include a previous surname if applicable
  • Please state which educational establishment
  • Previous Medical records

    Please help us trace your previous medical records by providing the following:
  • If you are from the UK

  • If you are from abroad

  • If you are returning from the armed forces

  • If you are registering a child under 5

  • If you need your doctor to dispense medicines and appliances

  • By submitting this form I confirm this information as true and correct as a patient or on behalf of a patient.
  • NHS Organ Donor Registration

  • Please tick the boxes that apply:
  • I confirm consent to organ donation.
  • (if different from above, e.g. place of work):