Skip to main content

New patient registration

New Patient Registration (PRF1)

Part A

Try to provide as much information as possible. If a question does not apply to you or the person you are registering write ‘Not applicable’ or ‘N/A’.

Are you registering:

Your details

Patient’s details

For example, 31/03/1980
What is your sex as recorded on your NHS record? *
Fixed address
Have you ever lived somewhere else in the UK?

The NHS and your GP surgery can use these details to call, text or email you about health care services. All phone numbers must be registered in the UK.

Any responses we send will go to this email address

Emergency contact

Are they your next of kin? *

Next of kin

For children under 12 months only

Where were they born?

For patients under 18 years

Do you attend any of the following?
Are any of these involved in your care?
Have you had all your routine vaccinations?
Did you get your routine vaccinations in the UK?

Additional information

What is your ethnic group?
White
Mixed or multiple ethnic groups
Asian or Asian British
Black/African/Caribbean/British
Other ethnic group
Have you registered with a UK GP before?
For example, 31/03/1980
Have you ever served in the UK Armed Forces or were you ever registered with a Ministry of Defence GP in the UK or overseas? *

If you were given a FMED133A form (sometimes called an FMED1 form) when you left the UK Armed forces, you should give this to your GP surgery.

Do you need an interpreter?
Sign language
Are you a carer?
What type of carer are you?
Do you have a carer? *
What type of carer are they?

You can sometimes collect your prescription items from your GP surgery instead of having to go to a pharmacy. Your surgery may discuss this with you.

Would you have serious difficulty getting medicines or appliances from your nearest pharmacy?

Sharing your Summary care record

Your GP surgery shares your important healthcare information with other healthcare professionals in England when they provide you with direct care, such as emergency care or referral to a specialist service. This is called a Summary Care Record (SCR).

Why we share your information

Your SCR is shared with healthcare professionals to ensure the quality and safety of your care. This reduces the risk of things like adverse medical reactions or delays in urgent care.

What information is shared

Your SCR contains details of your:

  • Medicines
  • Illness and health problems
  • Allergies and adverse reactions
  • Past operations and vaccinations

Your rights

You can choose not to share your SCR. However, this will mean healthcare professionals will not have access to important information about your healthcare.

If you do not want to share your SCR, speak to your GP.

If you are happy with your SCR being shared, you do not need to do anything.