You can now register as a patient at Market Overton and Somerby Surgeries using our online services.
Simply complete our New Patient Registration Form Online below.

New Patient Registration new

  • If Other Please Specify
  • Please help us trace your previous medical records by providing the following information
  • If You Are From Abroad
  • If You Are Returning From The Armed Forces
  • Supplementary Questions

    Anybody in England can register with a GP practice and receive free medical care from that practice.However, if you are not ‘ordinarily resident’ in the UK you may have to pay for NHS treatment outside of the GP practice. Being ordinarily resident broadly means living lawfully in the UK on a properly settled basis for the time being. In most cases, nationals of countries outside the European Economic Area must also have the status of ‘indefinite leave to remain’ in the UK. Some services, such as diagnostic tests of suspected infectious diseases and any treatment of those diseases are free of charge to all people, while some groups who are not ordinarily resident here are exempt from all treatment charges. More information on ordinary residence, exemptions and paying for NHS services can be found in the Visitor and Migrant patient leaflet, available from your GP practice.You may be asked to provide proof of entitlement in order to receive free NHS treatment outside of the GP practice, otherwise you may be charged for your treatment. Even if you have to pay for a service, you will always be provided with any immediately necessary or urgent treatment, regardless of advance payment. The information you give on this form will be used to assist in identifying your chargeable status, and may be shared, including with NHS secondary care organisations (e.g. hospitals) and NHS Digital, for the purposes of validation, invoicing and cost recovery. You may be contacted on behalf of the NHS to confirm any details you have provided.Please tick one of the following boxes

  • I declare that the information I give on this form is correct and complete. I understand that if it is not correct, appropriate action may be taken against me.A parent/guardian should complete the form on behalf of a child under 16.
  • European Economic Area (EEA) Country

    Complete this section if you live in another EEA country, or have moved to the UK to study or retire, or if you live in the UK but work in another EEA member state. Do not complete this section if you have an EHIC issued by the UK.

  • S1 Form
    Please tick if you have an S1 (e.g. you are retiring to the UK or you have been posted here by your employer for work or you live in the UK but work in another EEA member state). Please give your S1 form to the practice staff
  • How will your EHIC/PRC/S1 data be used? By using your EHIC or PRC for NHS treatment costs your EHIC or PRC data and GP appointment data will be shared with NHS secondary care (hospitals) and NHS Digital solely for the purposes of cost recovery. Your clinical data will not be shared in the cost recovery process. Your EHIC, PRC or S1 information will be shared with The Department for Work and Pensions for the purpose of recovering your NHS costs from your home country.

  • If you are applying on behalf of a child who is in foster care/residential care/Kinship care/or who is not your child
  • If other please enter the Name
  • If you are the parent/guardian/foster carer but cannot consent please detail below who can:
  • Data Sharing < /br>The SCR is a summary of your medical history that can be shared between healthcare staff treating patients in an emergency or out-of-hours with faster acceess to key clinical information. More information can be found by viditing digital.nhs.uk
  • Carer Details
  • Next of Kin
  • Medical Details
  • Rutland Stop Smoking Service: 01572 725805 www.rutlandrap.org.uk
  • Looked after Children
  • Social and Language
  • Please specify
  • Please specify
  • Please provide information below if known
  • (so we can send your prescription direct to them)
  • (Minors under 16 years old, adults lacking capacity)
  • Office use only
  • On-line services If there are any problems with your registration we will contact you to clarify any issues, but once your details have been entered into our computerised records you will be able to register with our on-line service provider (System One) and access appointments, prescriptions and some sections of your own medical record via the internet.

    All of the details that you need for this are available on our practice website on the online services page accessible from the home page.

    New Patient Health-check You may be eligible for a new patient health-check with a Practice Nurse/Health Care Assistant if you are on long term medication.

    Contact reception if you would like to take this up (Recommended).

    Thank you for providing this information. We look forward to providing you with a high standard of care in a friendly and professional manner.

  • NSH Organ Donor registration
    Please tick the boxes that apply.
  • NHS Blood Donor registration

    I would like to join the NHS Blood Donor Register as someone who may be contacted and would be prepared to donate blood.

  • (only if different from above, e.g. your place of work)