Registration With The Practice

You will need to come into the Practice and complete registration forms and a medical questionnaire.  Please bring your NHS card with you if possible.  If you are unsure whether you live within our Practice boundary (B76), please speak to one of the Reception Managers who will check for you.

We are unable to offer On-line Registration due to the restrictions on our practice boundary, which causes confusion for patients wishing to register with us but who live outside the B76 practice area.


Please complete this form and return it to Ashfield Surgery, Please also provide your proof of identity (copy of Passport or Driving Licence). Once we have received your form we will issue you with a registration letter which you use to register for your on-line account.


Please note that each individual family member would need to complete this application form as each individual needs to have their own account.

Email addresses should not be shared.