If you wish to register with Burbage Surgery, please print off and complete all registration forms for each member of the family wishing to register. All forms should be forwarded to the practice who will process your registration as soon as possible. You will need to provide us with one photographic form of ID and proof of your home address. We will write to you to notify when your registration is complete. The registration process normally takes up to 14 days.
PLEASE NOTE ALL FORMS AND A GMS1 MUST BE COMPLETED TO ENABLE THE REGISTRATION PROCESS TO BE STARTED
Accessible Information Form
From 31st July 2016 we are required to comply with the Accessible Information Standard. The standard aims to make sure that patients who have a disability or sensory loss get information that they can access and understand, and any communication support that they need.
New patients to the practice who are disabled or have a sensory loss should complete an "Accessible Information Form" found under "Accessibility information" on this website and submit this with their registration forms.
Registration Form GMS1 - This must be completed for each registration application Adults & Children
Burbage Surgery New Patient Registration Form Adult
Burbage Surgery New Patient Registration Form Child
Burbage Surgery Patient Contract