Online Pre-Registration

If you wish to register at Medlock Vale Medical Practice please complete the online registration form below. 

At present to keep our patients and staff safe, we encourage you to complete the form online.  Alternatively, you may print off a registration form, fill it out and drop it off at reception.

Registration form

When you visit the surgery for the first time you will be asked to sign the form to confirm that the details are correct. You will also be asked to provide photo identification and proof of your current address.  Please ensure you bring this with you.

When you register you are also required to fill out a medical questionnaire.  This is because it can take a considerable amount of time for us to receive your medical records. You can print this using the link below.  Alternatively, you can collect from the surgery.

New Patient Questionnaire