New Patient Registration

I am fully aware that this is a Private General Practice Surgery and that I will be charged a fee for all services rendered, which is explained on the website.
I confirm that all information declared above is accurate and I have not intentionally withheld any information about my/ my child’s health.
I consent to The GP Surgery Ltd processing information about me/ my child for the purposes of providing me/ my child with medical services and treatment.
I consent to the staff of The GP Surgery and affiliated organisations fully examining me / my child as long as it is appropriate to my / my child’s complaint. I understand my right to request a Chaperone if required.
I also consent to the GP Surgery referring me to a third party for appropriate investigations after obtaining my authorisation over the phone or by email.
By registering with The GP Surgery Ltd, I give my full consent to them communicating with me by post, email or telephone. I also consent to The GP Surgery Ltd not contacting me about my blood, laboratory and scan results (except in an emergency), unless I contact them using their Results interpreting service.