Register as a Temporary Patient

If you are ill while away from home, or if you are not registered with a doctor but need to see one you can receive emergency treatment from the local GP practice for 14 days.

After 14 days you will need to register as a temporary or permanent patient.

You can be registered as a temporary patient for up to three months. This will allow you to be our practice list and still remain a patient of your permanent GP.

After three months you will have to re-register as a temporary patient or permanently register with our practice.

To register as a temporary patient complete and submit this form.

Please note we need to verify your identification and residency. You will need to come into the Surgery in person with one Photo ID such as valid passport or drivers’ licence and with proof of residence, such as a utility bill addressed to yourself dated within the last 3 months.

Your registration will not be processed until you have provided the above documents.

Temporary Patient Registration

Temporary Patient Registration

Patient's Details

Please use this date format: DD/MM/YYYY.
Please let us know your preferred contact number in case we need to contact you.

Information about you

Details of treatment should be sent to:

To be completed by the doctor:

I declare to the best of my belief this information is correct and I claim the appropriate payment as in the SFA. An audit trail is available at the practice for inspection by the HA’s authorised officers and auditors appointed by the Audit Commission.