New Patient Registration: Registration Form (Part 1)

— New Patient Registration – Scotland – 01
Important: Please read the New Patient Agreement before completing the form. You must confirm your agreement to the terms to submit the form.

New Patient Agreement


Routine appointments:

For routine GP consultations, I can:

  • Phone from 8.30am for on-the-day appointments (telephone or face-to-face)
  • Book up to three days in advance for a pre-bookable face-to-face appointment
    • These appointments are limited and are available between 8.30-9.00am
  • Book up to one week in advance for 7.30-8.30am extended-hours telephone appointments

There is a limit to the appointments available each day and I am aware that I may need to call back.

The appointment system is subject to change.

I will only request an emergency appointment for a medical condition that I feel requires urgent treatment that same day.

To ensure I am directed to the correct Health Care Professional the staff may ask me for some brief details for the reason for my call.

Late attendance and failure to attend:

I agree to attend on time for all appointments that I book with the practice and cancel any that I cannot attend.

I acknowledge that if I arrive late for an appointment or fail to answer for my telephone consultation, I may be asked to rebook for another time.  I acknowledge that if I fail to attend or answer for 3 appointments the Practice may remove me from the List.

Home Visits

I accept that Home Visits are only for housebound patients or palliative patients who cannot attend the GP surgery. Home Visits should be requested before 10.30am.

Prescriptions

I agree to request any repeat prescriptions two full working days before collection.  It is my responsibility to ensure I have sufficient medication and I need to store this safely and securely.  Any medication requested that is not on my reorder slip is called a ‘special request’ and is not guaranteed.

Diazepam/Opioid/Controlled Drug Prescribing

The Practice is committed to a reduction programme for patients prescribed Diazepam, Sleeping Tablets, Opioid drugs eg Co-Codamol 30/500 and Controlled Drugs eg Pregabalin.

I accept that if I am on this medication I will require a medication review and this medication may be reduced or stopped.

Zero Tolerance Policy

I accept that all staff and GPs have a right to come to work without being subjected to aggressive behaviour.  The Practice has the right to remove me from the Practice List if my behaviour is deemed unacceptable.

A copy of the Practice Unacceptable Actions Policy and Zero Tolerance Policy can be found on our website or by asking at the Practice reception.

Messaging service

I consent to the practice contacting me by messaging service to the phone number registered on my file. I will update the Practice if I change my number.

Online Access

I am aware I can request to register for online access which will enable me to request my repeat medication.

Chaperones

I am aware that I can request a chaperone during consultations.  I will advise the clinician prior to the start of the consultation if I wish a chaperone.  The clinician may also request that a chaperone is present.

Have you read the New Patient Agreement and agree to the terms?
Sending