Registration With The Practice
If you wish to register click on the link below to open the form. When you have completed all of the details, please email it to firstname.lastname@example.org, along with your current proof of address (e.g a utility bill, bank statement, tenancy agreement, dated within the last 2 months).
Please note we cannot process you registration without proof of address and we can only register patients living within our catchment area (See Image below).
Shoreditch Park Surgery Registration Form
Shoreditch Park Surgery Registration Form For Children 5 years and under
You may need to download and install Adobe Acrobat Reader if you are using your phone to fill out the registration form.