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Camberwell Cars Ltd

Lockyer's Pharmacy


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HOW DO I...
REGISTER WITH THE PRACTICE?

In order to register with the Practice we will need to see your valid passport and proof of address (please check that you are living in our catchment area). You can pick up the relevant forms at reception and these must be completed in full. Once you have handed in your forms and copies have been taken of your ID, it can take up to three days to process your registration. You will be contacted once your registration has been accepted and you will be invited to undergo a new patient health check with the healthcare assistant. This will take up to 20 minutes and will review your personal medical history, family history, drug allergies, blood pressure, basic urine test, height and weight.

REGISTRATION ONLINE?

To register online please complete the form below-

Online Service Notice - Form Inactive

This form is not currently active!
Please use alternative methods available as described above and visit this online service again soon. For more information please contact the surgery. We apologies for any inconvenience caused.

REGISTER DETAILS
  Title:
Date of Birth:
Town & country of Birth:
NHS no. (if known):
Sex:
Surname:
First Names:
Telephone:
Mobile:
How you describe your
ethnic origin?
Email Address:
Address:
  Postcode:
Are you a carer for a sick/elderly person(s)?
Previous medical records
Your previous address in the UK
  Postcode
Name of your previous doctor at that address
Address of previous doctor
Are from abroad?
Your first UK address where registered with a GP
If previously resident in the UK, date of leaving
Date you came first came to the UK
Are returning from the Armed Forces?
Address before enlisting
  Service/Personnel No.:
  Enlistment date:
NHS Organ Donor Registration
I would like to join the NHS Organ Donor Register as someone whose organs may be used for transplantation after my death.
Please check as appropriate:-
Heart Liver Corneas
Lungs Pancreas Any part of my body

CONFIDENTIALITY - TERMS AND CONDITIONS:
The internet is not secure, and the transmission of this data is entirely at the patient's own risk. The practice accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

I accept the terms and conditions above

On receipt of your completed application, we will send you a pack with details of our practice and contact you to organise a new patient check.
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