If you would like to register with the practice please use this form.

After Registration

Upon registration you will be offered a ‘New Patient Appointment’ with the Nurse.  If you are taking any regular medication, please bring this to your first appointment so that we can add it to your records – it can take several weeks for us to receive your medical notes.

Please note that if you move outside our practice boundary, we are unable to keep you on our list. Please telephone Primary Care Support England on 0333 014 2884 to find a surgery.

Practice Area

• Ampthill
• Maulden
• Flitwick
• Westoning
• Greenfield
• Flitton
• Houghton Conquest
• Wilstead, Clophill
• Haynes (West and Church Ends)
• Millbrook
• Marston Moretaine
• Lidlington
• Wixams
• Stewartby
• Pulloxhill
• Steppingley

View the practice boundary map

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NHSFamily doctor services registrationGMS1

Patient's Details

Title *

Mr

Mrs

Miss

Ms

Other

Please specify:

Surname: *

Previous Surnames:

First Name(s) *

Date of Birth: *

Please use this date format: DD/MM/YYYY.

Gender *

Male

Female

NHS Number: *

Home Address: *

Postcode: *

Town and Country of birth: *

Home Phone Number:

Mobile Phone Number:

Work Phone Number:

Email Address: *

Can we contact you by text?

Yes

No

Can we contact you by email?

Yes

No

Previous Details

Previous address in UK:

Please include postcode.

Name and address of previous GP:

If you are from abroad

Registering for the first time in the UK

Date you came to live in the UK:

Please use this date format: DD/MM/YYYY.

If you are returning from abroad

Previously been a resident in the UK

Date you left the UK:

Please use this date format: DD/MM/YYYY.

Date you returned to the UK:

Please use this date format: DD/MM/YYYY.

If you are registering a child under 5

I wish the child above to be registered with the doctor for Child Health Surveillance

If you need your doctor to dispense medicines and appliances

I live more than 1 mile in a straight line from the nearest chemist

I would have serious difficulty in getting them from a chemist