New Patient Registration

If you would like to register with the practice please use this form.

To register a new patient you will need to live within our practice boundary.

Please help us to process your registration quickly by obtaining your NHS number from your previous GP practice.

New Patient Registration - Surrey Lodge

Patient's Details

Title: *
Please use this date format: DD/MM/YYYY.
Please use your current Manchester address.
Please use your current Manchester address.
Please use your current Manchester address.
Which of the following best describes how you think of yourself?
Is your gender identity the same as the gender you were given at birth?
Do you consent to us sending you text messages relating to your care e.g. appointment reminders and when we need you to contact the surgery?
Any responses we send will go to this email address.
Can we contact you by email?