New Patient Registration Form

All requests will be reviewed by a Doctor before acceptance & is dependent on practice capacity. Please note preference is given to patients living in the locality.

Full Name*

Date of Birth*

Gender*

PPS Number*

GMS/DVC Number

Contact Number*

Email*

Previous GP*

Drug Allergies*

I consent to be contacted by text message*

Attach Files

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The Next Steps

If accepted by the practice, please complete the "Transfer of Medical Records" form below to ensure we can obstain a copy of your medical records.

If you have a medical or doctor visit card please complete the "Change of GP Form".

New Patient Registration Form (pdf)Download

Transfer of Medical Records (pdf)Download

Medical Card or GP Visit Card Change of GP Form (pdf)Download

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