Masham Road

Cantley, Doncaster

South Yorkshire

DN4 6BU

© All rights reserved  The Oakwood Surgery.

Terms and conditions | Report an error on our website | Contact Us

Routine - 01302 537611

Emergency - 01302 371399

Fax - 01302 371804

Email - oakwood.surgery@nhs.net

Practice code - C86012

Oakwood Surgery The Care for all the family, from sapling to great oak.

First name

Surname

DoB

Address

Post Code

Smoker?

No

Yes

If yes, how many do you smoke per day?

Alcohol?

No

Yes

If yes, how many units of alcohol do you drink per week?

Please attach a photo ID, such as a copy of your passport of driving licence.

Weight (kg)

Height (cm)

Home Tel Number

Mobile

E-mail

Ethnicity

First language

Have you served in the armed forces as a regular, reservist or are you a dependant of someone who has?

No

Yes

For online registration, we need two items of proof of who you are (only if > 5 years of age)

Please attach proof of your address, such as a household utility bill.

Are you a carer?

No

Yes

Do you have a carer?

No

Yes

If you have a carer, please tell us their name and contact details below

Full Name

Relationship to you

Contact details

Personal

Current Health Challenges

Do you have and of the following conditions?

Asthma

Diabetes

Kidney Disease

Heart Problems

Non-Functioning Spleen

High Blood Sugars

Epilepsy

Stroke

COPD / Bronchiectasis

Cancer

No

No

No

No

No

No

No

No

No

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

We are an Armed Forces Friendly Practice

Carers

How often do you take exercise?

We define this as at least 30 minutes of activity that makes your heart beat faster and makes you sweaty.

Healthy Living

Most recent blood pressure

(If known)

/

Consent



I give my permission for The Oakwood Surgery to contact me via email or telephone





I give consent for The Oakwood Surgery to send me text messages




I confirm that I am who I say I am and indemnify The Oakwood Surgery against any losses that might arise from my acting fraudulently.

Do you have any allergies?

No

Yes

If yes, please tell us what you are allergic to

To make it easier for us to provide you with continuity of care, you might want to upload a copy of your recent prescription from your previous GP practice.

Medications

To register as an NHS patient, we also need you to complete a GMS1 form.  Feel free to print this out, scan it back on and sent it to us electronically.


Download the GMS 1 form here

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After clicking submit, you will be redirected to our new patient information page

Online registration.


We are thrilled that you want to register with us.  To make it easier, we’ve created an online form so you can register with us from the comfort of your own home.  


What you will need…