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New patients

We welcome new patient registrations to Medwyn Surgery. Anyone who lives within our catchment area can register with the practice. To check if you live in the practice area click here.

To register online please complete the following form. You don't need to fill in every section but please check the form carefully and give us as much information as you have available. If you want to register the whole family you will need to submit a separate form for each family member.

Personal Information
(Required)
(Required)
(Required)
If applicable
(Required)
(Required)
Please enter your date of birth in the format dd/mm/yyyy
(Required)
If born in London, please give District
(Required)
(Required)
Required if 'Other' has been selected in ethnic group
Contact Details
(Required)
Please enter your current address
(Required)
(Required)
(Required)
Please enter a contact telephone number
Previous information
Please help us to trace your previous medical records by providing your previous address (if applicable)
Please enter the name of your Previous Doctor if applicable
If you are from abroad
If any
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Additional Information
I wish the child above to be registered with the doctor named overleaf for Child Health Surveillance
I live more than 1 mile in a straight line from the nearest chemist
I would have serious difficulty in getting them from a chemist
Donor registration
I would like to join the NHS Organ Donor Register as someone whose organs may be used for transplantation after my death.
Kidneys  Heart  Liver  Corneas  Lungs  Pancreas  Any part of my body
I would like to join the NHS Blood Donor Register as someone who may be contacted and would be prepared to donate blood
Tick here if you have given blood in the last 3 years