Registration with the practice
Before filling out any of the registration forms, please check on the catchment area tab (above) that you are able to register with this surgery by entering your postcode. At this time we are only able to accept patients onto our list who reside within this area. This is to ensure the saftey of all our patients.
If you wish to register click on the link below to open the form. When you have completed all of the details, print and bring the signed form to the surgery.
Registration Form (Front Page)
Registration Form (back page)
When you register you will also be asked to fill out a number of forms, which includes a medical questionnaire. This is because it can take a considerable time for us to receive your medical records. There is an online version of this file too, which you may fill out and send to us. When you come to the surgery you will be asked to sign this form to confirm that the details are correct.
Please also look at the 'Carers' sections of this website as there may be some information and forms that are relevant to your circumstances. All the forms for registration can be found at the bottom of this page. It is important that we have them all correctly. If you prefer you could visit the surgery where we have pre printed packs for you to take away.
Within 3 months of registering with us you will need to make an appointment with one of our nurses, for a new patient check. They can go through any medical conditions you have and ensure we have the correct information about you and your health.
Online medical questionnaire for new patients
Note that by sending the form you will be transmitting information about your self across the Internet and although every effort is made to keep this information secure, no guarantee can be offered in this respect.
Please review the following forms, printing and completing any which may be relevant. We will then need these forms along with the registration form when you visit the surgery to register.
Welcome to the Moat House Surgery
Audit C Questionaire
Summary Care Record
Are you a carer?