Langham Place Surgery welcomes new patients who reside permanently within the practice area boundaries - please check our Practice Area information sheet to confirm our practice area.
For each applicant applying to register you will need to provide the following:
You will also need to complete the following forms:
For your convenience these forms can be printed by clicking on the appropriate icon or you can pick up a registration pack from reception.
Childhood Immunisation History Form
You will need to bring all your documents and completed forms to reception for checking.
If you are on any repeat medication the receptionist will arrange a new patient health check appointment.
| 1. Home Address - | Where you are living now |
| 2. Previous Doctor - | The last doctor you were registered with |
| 3. Previous Address - | Where you lived when you were registered with your previous doctor |
4. If you have only just arrived in the UK and have never been registered with a GP please give the date you arrived.
5. Please do not forget to enter your Date of Birth and to sign the form.
An area drawn roughly in line with a 2 mile radius of the surgery but based on major roads. This is described as follows: