New Patient Registration (Under 16s)

Thank you for registering with the Lakeside at Oundle Medical Practice. Before filling in your registration forms, please read very carefully through this information sheet to ensure that you complete this form correctly, and that you provide the necessary documentation to support your registration form.

For patients already registered within the NHS:

• If you are registering and you are currently at another practice, please can you ensure your NHS number is on the form as without this we are not able to register you here. The importance of this is to ensure that we locate the correct record for you, and do not register another patient with the same name and date of birth as you. Believe it or not, this has been known to happen at a handful of surgeries across the country. If you cannot find your NHS number, please contact your previous surgery who will be able to give this information to you.
• Please add your previous surname.
• Please ensure you provide a FULL previous address, Swansea Uni (for example) will not suffice.
• Please ensure that your form is legible and that you write clearly to ensure that the information we enter on to the system is accurate.
• If you have lived abroad and are returning, please enter the date you left the UK and the date you re-entered the UK.
• If you have been enlisted in the army, please provide the dates you joined, and the dates you left. (Believe it or not the health authority DOES need this information.)
• Please sign and date the pink GMS1 form where it says ‘signature of patient’
• Please ensure you fill in the registration questionnaire as accurately as possible and all other forms attached.
• Please bring with you one piece of photographic ID (passport, full or provisional driving licence) or a birth certificate AND proof of address. This could be a bank statement, a tenancy agreement, wage slip, utility bill with your most recent address. If you do not currently have anything in your name, we are able to register you but you will not be able to access to our online system. All patients the age of 16 and over will need to present with these registration forms themselves in person. We do understand that some patients who are 16 and 17 will not have sufficient photographic ID and in these exceptional circumstances we are able to register these patients, but we will require ID from the parent. If you do not have the required documentation please call the surgery on 01832 273408 and ask to speak to the admin team who will be able to advise.

For patients who have lived overseas registering permanently:

• Please ensure that your form is legible and that you write clearly to ensure that the information we enter on to the system is accurate.
• Please enter all previous surnames.
• Please add any addresses (or locations) you have lived in the UK at any time in your life, even if you think you did not register at a GP surgery at that time.
• Please add the date you entered the UK.
• Please sign and date the bottom of your form.
• Please ensure you fill in the registration questionnaire as accurately as possible and all other forms attached
• Please bring with you your passport or visa and one piece of evidence to support where you live. This could be a bank statement, utility bill, phone contract, wage slip, tenancy agreement or a letter from your landlord.
• Please bring a birth certificate for all persons under 16.

It is of enormous benefit to the Doctors and Nurses to know something about your child's medical background when you visit the practice since we may not have received your child's notes from your previous practice for some time.
Please note all fields marked with a * are mandatory for your registration

What does "nominate a pharmacy" mean for me?

Please submit birth certificate as proof when prompted.

Previously been registered with the NHS in the UK

These are supplementary questions and your answers will not affect your registration with us

Anybody in England can register with a GP practice and receive free medical care from that practice.

However, if you are not ‘ordinarily resident’ in the UK you may have to pay for NHS treatment outside of the GP practice. Being ordinarily resident broadly means living lawfully in the UK on a properly settled basis for the time being. In most cases, nationals of countries outside the European Economic Area must also have the status of ‘indefinite leave to remain’ in the UK.

Some services, such as diagnostic tests of suspected infectious diseases and any treatment of those diseases are free of charge to all people, while some groups who are not ordinarily resident here are exempt from all treatment charges.

More information on ordinary residence, exemptions and paying for NHS services can be found in the Visitor and Migrant patient leaflet, available at reception. Alternatively for more information go to the NHS Website 

You may be asked to provide proof of entitlement in order to receive free NHS treatment outside of the GP practice, otherwise you may be charged for your treatment. Even if you have to pay for a service, you will always be provided with any immediately necessary or urgent treatment, regardless of advance payment.

The information you give on this form will be used to assist in identifying your chargeable status, and may be shared, including with NHS secondary care organisations (e.g. hospitals) and NHS Digital, for the purposes of validation, invoicing and cost recovery. You may be contacted on behalf of the NHS to confirm any details you have provided.

I declare that the information I give on this form is correct and complete. I understand that if it is not correct, appropriate action may be taken against me.

LIST OF EEA COUNTRIES

If you are visiting from another EEA country and do not hold a current EHIC (or Provisional Replacement Certificate (PRC))/S1, you may be billed for the cost of any treatment received outside of the GP practice, including at a hospital.

Please enter the details from your EHIC or PRC below.

A carer is anyone, including children and adults who looks after a family member, partner, or friend who needs help because of their illness, frailty, disability, a mental health problem or an addiction and cannot cope without their support.

This does not mean your normal parenting duties for your child

You will need to provide a copy of the birth certificate to the practice as soon as the child is registered

What happens to my information?

Personal and medical information about patients registered at this practice are primarily kept electronically, although some is kept in paper form. Some information will be sent to hospital consultants and other health professionals to whom you are referred by your GP in order to provide continued healthcare and obtain treatment for you.

We sometimes use accredited suppliers for our communication with you, for example when we send recall letters for review clinics or medication reviews. All suppliers we use are checked carefully to ensure they comply with strict confidentiality protocols.

To ensure the security of all patient information, all staff that has access to your records is covered by confidentiality clauses in their contracts and the Data Protection Act and the Freedom of Information Act. Our guiding principle is that we hold your records in strict confidence.

I certify that the information I have provided is correct and consent to my personal and medical information being used as stated above.