Care Home Residents Registration

 

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Please complete our online form

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This form is for registering care home residents only.

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Preliminary Questions
 
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Patient's Details

Information we need to register you with the practice
Please note all fields marked with a * are mandatory for your registration

Previous Details
Please include postcode
 
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Medical Information
Advanced Decision/Planning Future Care/etc?
End of Life Care Hub

Please check and include as much information about current medications below. If there are any MARS, patient summary from previous GP practice or a hospital discharge summary please upload these at Part 3 of the registration.

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Patient Specific Information
 
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Sharing Your Health Records

This option means that we are unable to share information with organisations such as the community nurses and proactive care which could delay care which is required.

Patient Declaration

For all patients who are not ordinarily residents in the UK

Anybody in England can register with a GP 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 from your GP practice.

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 immediate 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 organisation (e.g. hospitals) and NHS Digital, for the purposes of validation, invoicing and cost recovering. You may be contacted on behalf of the NHS to confirm any details you have provided.

Please tick one of the following boxes:

A parent/guardian should complete the form on behalf of a child under 16.
European Economic Area (EEA) Country

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.

Additional Information
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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.

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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