Patient Registration

To register with the practice please use this form.

To book an appointment, you will need to book a video consultation through the NHS app.

Please view the NHS App Video Consultation booklet for more information.

Patient Registration Form (Salisbury Walk In Centre)

Patient's Details

Title *
Sex *
Can We Contact You By Text? *
Can We Contact You By Video? *

What Happens To My Information?

Personal and medical information about patients registered at this practice are primarily kept electronically, although some is kept in paper form. Some information will be sent to hospital consultants and other health professionals to whom you are referred by your GP in order to provide continued healthcare and obtain treatment for you.

I certify that the information I have provided is correct and consent to my personal and medical information being used as stated above.