Register as a Patient of the Practice
If you wish to register with the Practice, click on the link below and complete the form. When you have completed all of the details, click on the "Send" button to mail your form to us. When you visit the surgery for the first time you may be asked to sign the form to confirm that the details are correct.
When you register you will also be asked to fill out a medical questionnaire. This is because it can take a considerable time for us to receive your medical records. There is an online version of this below, which you may fill out and send to us. When you come to the surgery you may be asked to sign this form to confirm that the details are correct.
If you have any regular or repeat medications, you will need to make an initial appointment with a GP Partner, Dr Al-Ausi or Dr Wise. Please contact the practice on 0161 426 0011 to make this appointment.
Online Medical Questionnaire*
*Please make sure you are a current patient / or have completed the Registration form above before completing this Medical Questionnaire.
Note that by sending the form you will be transmitting information about yourself across the Internet and although every effort is made to keep this information secure, no guarantee can be offered in this respect.
If you are registering with the Practice, please find forms below for you to complete with regards to opting out of Data Sharing.
Data Sharing Opt Out Forms
ED department access to patient records letter 2017
ED Patient Opt Out Request for all data sharing 2017
Data Provision Notice for Planning and Research
National Data Opt Out
Data Provision Notice.
This mandates us to share information about you unless you tell us not to.
NHS Digital has issued a Data Provision Notice for Planning and Research under section 259 (1) of the Health and Social Care Act 2012. This mandates us to share your information with them unless you tell us not to.
This data sharing relates to your health data being extracted for secondary use of data purposes eg analysis, research, planning etc. It is not related to primary, direct care purposes.
If you do not want to share your data for secondary care use purposes you must complete a Type 1 and Type 2 opt out (National Data Opt Out)
(a) Type 1
The Type 1 opt out relates to information held on your medical record at the Practice
(a) Type 1
The Type 1 out out relates to preventing information held on your medical record at the Practice from being shared for research and planning purposes
To opt out please complete and return the form below before 23rd June 2021.
Type 1 Opt Out form
(b) National Data Opt Out (previously known as Type 2)
This allows you to opt out of any of their confidential data held by other organisations with the NHS being used for research.
To complete this online submission click here
You can see a list of the Data Provision Notices here: https://digital.nhs.uk/about-nhs-digital/corporate-information-and-documents/directions-and-data-provision-notices/data-provision-notices-dpns
Patients can view or change their national data opt-out choice at any time by using the online service at www.nhs.uk/your-nhs-data-matters or by calling 0300 3035678.
Alternatively, you may print off a registration form, fill it out and bring it in with you on your first visit to the practice.
Named GP: As from June 2015 we are obliged to inform patients that they have a “named GP”. This has no bearing at all on which GP you currently see and / or wish to see in the future.