Useful Forms to Download and Complete

To register as a new patient please complete and download the following Registration Form and New Patient Questionnaire.

You will also need to provide Photographic ID and proof of address. If you do not have any of this documentation, please make sure the surgery staff are aware when you bring your paperwork back so they can assist with your registration.


Family Doctors Registration Form

New Patient Questionnaire
Please complete this Questionnaire if you wish to Register with our Practice. Click on link below to download the form.
Microsoft Word document [68.0 KB]
Online Access Application Form
Please download and complete this form if you wish to have Online Access to your Medical Record (to Book Appointments and order Repeat Medication etc.). Click on link below to download this form.
On Line Access Application Form.doc
Microsoft Word document [110.0 KB]
Travel Risk Assessment Form
Please download and complete this form if you are wishing to Travel and have made a Travel Appointment with the Nurse. Please note: the Nurse must have this completed form 3 days prior to your booked appointment. Click on link below to download this form.
Microsoft Word document [85.5 KB]

We are located at:

Eastwood Group Practice

335 Eastwood Road North



If you have any queries or wish to make an appointment, please contact us:


01702 529111


01702 421888

RAYLEIGH ROAD  01702 525289

Click on Links below:-

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