Registration Form

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  • Third Party Information
  • Health Information

Registration Requirements

Demographic Details

Your Current Address

Your previous address

You do not need to enter this if your address when registered at your previous GP is the same as your current address. NHS England uses this to identify your medical records held at your previous GP Practice.

Contact Details

Please tick the box below to confirm that by providing your email address and/or mobile phone number Parliament Hill Medical Centre may convey personal medical information to you via email and/or text message. Thank you.