Translate

Veteran Registration

Page {{ paginatorProps.current }} of {{ paginatorProps.total }} ({{ paginatorProps.percentage }}% completed)

All questions marked with a * are mandatory

Patient's Details

Title: *

Gender at birth: *

Do you identify differently?:

Do you have a nominated pharmacy for electronic prescribing?:

Nominate a pharmacy means we can send any prescriptions directly to the pharmacy without you needing to come to the surgery

include the full address and post code of your chosen pharmacy

Are you happy for us to contact you by email?: *

Are you happy for us to contact you by text message? : *

Processing

Your NHS Number

Help us to help you

You do not need to know your NHS number to use NHS services. However, providing this reduces the time it takes to process your registration. It helps us get you registered quicker.

How to find your NHS Number

Enter your NHS Number:

Processing

Were you ever registered with an Armed Forces GP

Have you ever served in the UK Armed Forces or were you ever registered with a Ministry of Defence GP in the UK or overseas?: *

If you were given a FMED133A form (sometimes called an FMED1 form) when you left the UK Armed forces, you should give this to your GP surgery.

These questions are optional and your answers will not affect your entitlement to register or receive services from the NHS but may improve access to some NHS priority and service charities services

Please indicate if you have served in the UK Armed Forces and/or been registered with a Ministry of Defence GP in the UK or overseas:

Processing

Privacy Consent

This form collects personal and medical information about you and 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.

Processing

There appears to be a problem loading the form, please refresh the page.
If the error persists please contact us.