New Patient Registration

 

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Patient's Details

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Information we need to register you with the practice
Please note all fields marked with a * are mandatory for your registration

Ethnicity & Religion
Previous Details
If you are from abroad
Lifestyle
Your Personal Alcohol Consumption

alcohol consumption Image 1 unit

Alcohol unit guidelines

UK alcohol unit guidance: CMOs' Low Risk Drinking Guidelines

To keep health risks from alcohol to a low level, the UK Chief Medical Officers (CMOs) advise it is safest not to drink more than 14 units a week on a regular basis. The CMO also give guidance on drinking in pregnancy and single occasion drinking.

For more information about drinking guidelines and understanding units visit Drink Aware.

Turning Point

Turning Point offers you or a loved one a range of services depending on what you need, from detox and residential rehab to supported living and aftercare support. Click  here  to see more information. 

If you would like support with alcohol issues. Please tick the box below to be referred.

 
 
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Free latent TB testing and treatment

Free Latent TB Infection and Screening Programme

We are offering free testing to diagnose latent TB; treatment is easy and helps prevent developing TB in the future. Latent TB does not have any symptoms, therefore the only way to find out if the bacteria is not active in your body is to get tested. If you meet all the criteria below on either questions one or two, let one of our receptionists know or book an appointment with our Practice Nurse. We may also send you a text message after your registration inviting you in for an appointment.

 

Criteria 1

  • Are you aged between 16-35?
  • Have arrived in the UK within the last five years?
  • Have lived in one of the countries listed below for more than 6 months?
  • No history of TB either treated or untreated

Criteria 2

  • Are you aged between 16-35?
  • No history of TB either treated or untreated
  • Ex-prisoner, alcohol misuse, current/ex-drug user
  • Never screened for TB in the UK

List of high-incidence countries

Afghanistan, Angola, Bangladesh, Benin, Bhutan, Botswana, Burkina Faso, Burundi, Cote d’Ivoire, Cabo Verde, Cambodia, Cameroon, Central African Republic, Chad, Comoros, Congo, DRP Korea, DR Congo, Djibouti, Eritrea, Equatorial Guinea, Ethiopia, Gabon, Gambia, Ghana, Greenland, Guinea, Guinea Bissau, Haiti, India, Indonesia, Kenya, Kiribati, Laos PDR, Lesotho, Liberia, Madagascar, Malawi, Mali, Marshall Islands, Mauritania, Mauritius, Micronesia, Mongolia, Mozambique, Myanmar, Namibia, Nepal, Niger, Nigeria, Pakistan, Papua New Guinea, Philippines, Republic of Moldova, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, Somalia, South Africa, Sudan, Swaziland, Timor Leste, Togo, Tuvalu, Uganda, UR Tanzania, Zambia, Zimbabwe

 
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Summary Care Record

Summary Care Record (SCR)

The Summary Care Record (SCR) system is designed to help both your GP and any emergency staff you contact when the surgery is closed to treat your health needs more efficiently.

Your information will be shared between your GP practice, our local hospital and Out Of Hours service. This will enable your GP surgery to access results and any visits you have at the hospital quickly and efficiently, but it also means that if you have an emergency and contact the Out Of Hours service or visit A&E they will have access to your current medications as well as allergies and are better able to treat you.

If you do not return this form, a Summary Care Record will be created for you based on implied consent

EMIS Sharing Consent

In addition to the practice opening hours, patients in City & Hackney have access to GPs and Practice Nurses appointments at other GP Practices from 6.30pm - 8.00pm Monday to Friday and from 8.00am - 8.00pm Saturday and Sunday as part of the Extended Hours GP Access Service. Opting in for data sharing will allow us to book you in for evening and weekend appointments when requested.

 
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What happens to my information?

Personal and medical information about patients registered at this practice are primarily kept electronically, although some is kept in paper form. Some information will be sent to hospital consultants and other health professionals to whom you are referred by your GP in order to provide continued healthcare and obtain treatment for you.

We sometimes use accredited suppliers for our communication with you, for example when we send recall letters for review clinics or medication reviews. All suppliers we use are checked carefully to ensure they comply with strict confidentiality protocols.

To ensure the security of all patient information, all staff that has access to your records is covered by confidentiality clauses in their contracts and the Data Protection Act and the Freedom of Information Act. Our guiding principle is that we hold your records in strict confidence.

I certify that the information I have provided is correct and consent to my personal and medical information being used as stated above.

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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