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Last Updated: 24/11/2023
Information about you
If you did not wish to disclose this information please say this in the text box below
Consent to contact
Next of Kin
Your next of kin details are requested so we are able to contact a family member or friend if you are needing assistance at the surgery.
Third Party Consent
Your third party contact will be someone who can organise appointments on your behalf, collect prescriptions or fit notes and discuss your care with a clinician. Please be advised that your next of kin and third party are listed separately as they will have different permissions on your medical file.
Please note once a patient reaches their 16th birthday, they will need to complete a consent form in order for their third party contact to discuss care with a clinician, on behalf of the patient. This includes immediate family members.
Where would you like to collect your prescriptions?
This GP practice is able to share your electronic GP record with healthcare professions caring for you elsewhere e.g. in community, hospital or urgent care services. This may help in your care and may save you from needing to remember your medical history and medications. This surgery uses a computer system called SystemOne that allows the sharing of full electronic records across different health services if patient consent is given. There are two ways in which your information can be shared.
Sharing Out - This controls whether your information entered at this surgery can be shared with other NHS services
Sharing In - This controls whether information that has been made shareable at other NHS services can be viewed by the surgery
Access to System On Line and NHS App
This will provide you access to request ongoing medication, to book some clinician appointments and access to prospective Full Record Access
Please help us trace your medical records by providing the following information
If you are from abroad
Please note that if you have not been registered with a GP Practice before and were not born in the UK we will need the date you came to the UK to be able to register you.
Were you ever registered with an Armed Forces GP?
Medicines and Appliances
*Not all doctors are authorised to dispense medicines
Routine HIV Testing at Park Crescent
HIV (Human Immune-Deficiency Virus) is a virus which attacks the body's immune system, making it difficult to fight infections. The only way to identify the people affected is to encourage everyone to have a HIV test.
We offer routine HIV tests on all our patients as recommended by the Department of Health, either on registration or as part of routine care. This is because:
Please book an appointment if you would like to take a test, or let the clinician know at any routine blood test appointments.
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