Please complete this registration form ensuring all required fields are completed. Submitting this form will register you with The Manor Surgery in Beeston, Nottingham.
Before registering with the surgery, please ensure that you are living within the surgery's catchment area by clicking here.
Please note that if you are trying to register a new born baby, the forms will need to be collected from the surgery.
If this is your first time registering with an NHS GP Practice, you will need to fill in a GMS1 form. This form can be collected from the surgery.
If you have any issues with your registration please contact the surgery directly.
Last Updated: 02/03/2023
Patient Details
Please check that all data is correct and spellings are accurate as this will affect your registration.
Current Home Address
Please be aware that we can only register patients who live within our catchment area. If you are unsure whether you live in our catchment area please contact the surgery.
Contact Details
Please provide us with at least one contact number and ensure these are correct and up to date. Failure to do so will halt your registration.
Next of Kin
Previous GP Practice
In order to obtain your medical records from your previous GP please provide the following information:
Additional Information
Nominated Pharmacy
SMS – Text Messaging Service
Patient Health Questionnaire
Smoking Status
Please answer the following question regarding your smoker status.
Alcohol Intake
Carers
Support for Dealing with Homelessness
The Practice offers support for people who are homeless.
Support for Asylum Seekers
The Practice offers support for assylum seekers.
Summary Care Record (SCR)
EDSM- Enhanced data sharing model
The EDSM allows your GP to share your record with other healthcare providers. This will help to deliver better and safer care for you.
Online services
We offer an online service through the NHS app. With this service you can order your repeat prescriptions online, book appointments and view your medical records. You can sign up for this service directly through the NHS app. Simply download the NHS app from the app store on your smart phone or tablet and follow the in app instructions. If you require any additional support please follow the NHS app links on our website or contact the surgery direct. Please note that you will have to provide ID to access these online services.
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