Online 'Pre-Registration' With The Practice

Practice Area

Our practice covers a 5 mile radius on the west bank of the River Foyle.
All currently registered patients residing outside of this area will remain registered with the practice unless they move to a new address outside of the boundary area.  In this case patients will be removed from the practice register and advised to seek registration with an alternative practice.

PreRegistrationIf you wish to pre-register click on the link below to open the form. When you have completed all of the details, click on the "Send" button to mail your form to us.

Pre-registration Form

On receipt of the application you will receive a letter to confirm if your application has been successful or unsuccessful.

If successful you will be asked to call at the surgery to complete the registration form and be advised of other documentation that is required.

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.

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