Chilcote Surgery Telephone Number

Register as a new patient


Please see here for our current catchment area.

For more information about the surgery, you can view our Patient Information Leaflet here.

If you have Adobe Acrobat Reader installed on your PC you may download the necessary registration forms from the links below:

Please either print these forms or collect them from the surgery and return them to us. You can return your pack to the registration post box (formerly for prescriptions) inside the porch area, or hand them into reception with photo identification such as a photo driving licence or passport. Photo ID is necessary for security reasons to ensure that access to your records and medication is only issued to you. If you are leaving your registration pack in the post box with ID, please use a photocopy. Please note that the purple form must be signed. Please allow 10 working days from handing in your forms to us for your registration to be completed. You will be a registered patient once you receive your welcome letter.


PLEASE NOTE: You will need to print both the purple registration form and the new patient questionaire form!


You may be encouraged to attend for a New Patient Check with the Healthcare Assistant.  This is an important first contact for your new surgery.  Please bring a urine sample with you.

New Patient Questionnaire

Patient Consultant Group Form

Summary Care Record Opt Out Form Only fill this form out if you wish to opt out of having a summary care record. Please read the document for details.

After your registration is completed you will be able to register for online services. For more information please follow this link.

CQC Report

National Diabetes Audit