Online 'Registration Form' With The Practice

If you live within the Practice boundary area (which covers roughly an 8 mile radius – a more detailed map is available in the surgery) and wish to register with Ravenswood Surgery click on the link below to open the form. When you have completed all of the details, click on the "Send" button to mail your form to us. You must then visit the surgery to complete the registration process and you will be asked to sign the form to confirm that the details are correct. Please ensure that you bring identification with you when you visit the Practice which confirms your current address.  You will also be asked to complete further Practice paperwork to complete your registration.

Fields marked with a red asterisk are

You should only send this form if you are sure that you are eligible to join this practice.

Sending this form will NOT automatically register you with the surgery.

Your form will be kept at the surgery and must be signed by you when you attend the Practice to complete the registration process.

Sending this form does NOT guarantee or even imply that you will be accepted onto the practice register


Pre-Registration Form

When you register you will also be asked to fill out a medical questionnaire. This is because it can take a considerable time for us to receive your medical records. There is an online version of this file too, which you may fill out and send to us. When you come to the surgery you will be asked to sign this form to confirm that the details are correct.

Online Medical Questionnaire For New Patients

Note that by sending the form you will be transmitting information about your self across the Internet and although every effort is made to keep this information secure, no guarantee can be offered in this respect.

Alternatively you may print off a registration form, fill it out and bring it in to the Practice.

pdfRegistration Form

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