New Patient Registration

If you live within our boundary area and would like to register with the practice please use this form.

Once you have completed the form you will be required to visit the surgery providing proof of address.

Temporary Registration

You can register as a temporary resident if you are staying with one of our registered patients for up to three months. You can register temporarily with a GP while away from home for work, study or holiday. You’ll still remain registered with your permanent GP.

New Patient Registration - Wilbraham

Patient's Details

Title *
Please use this date format: DD/MM/YYYY.
Please use your current Manchester address.
Please use your current Manchester address.
Please use your current Manchester address.
Any responses we send will go to this email address.
Are you a student?
Do you consent to results and other messages about your personal health being sent by email?
Do you consent to results and other messages about your personal health being sent by text message?