651a Fulham Road, London SW6 5PX

Register with us

Thank you for choosing to register with us.

In order to register you need to live within a certain distance of our practice – please call us if you wish to confirm that you live within our ‘practice area’. If you live outside this area, your registration may be rejected (This does not apply to all students)

Please complete the following fields as fully as possible, this will help us to process your details. We will contact you to acknowledge receipt of your registration. The first time you attend the practice for an appointment we will need to ask you to complete a brief form and provide us with proof of identity.

Please note that we cannot currently accept registrations for children online. You need to be over 16 to use this service. Children are very welcome to register with us, but a parent or guardian needs to visit the practice to complete the form in person

As a security measure all information provided on this form will be sent as a secure, encrypted email.

* indicates required field
For your DOB use the format: date, month, year

Please provide your current address details
If born in the UK please also state the county & town where you were born
We need your previous doctor’s details to help us to trace your medical records. Please enter your previous doctor's name, surgery name, full surgery address. If you have not previously had a UK GP, please enter “none”

Next should be the home address you used when registered at your previous doctor's surgery
If you have not previously had a UK GP please state when you moved to the UK
Please enter your NHS number
ALCOHOL CONSUMPTION Q1
ALCOHOL CONSUMPTION Q2
ALCOHOL CONSUMPTION Q3
If you are a UAL student please state which campus you attend

Check your postcode

Enter your postcode to check that you live within the practice boundary