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Wickham Park Surgery
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Registering

We can only accept registrations from patients that currently reside in our practice area. Please use our online Practice Area tool to see if you are within the surgery boundaries.

Patients wishing to register at the practice can download and print the necessary forms found below. Alternatively registration packs can be collected from the surgery if you do not have access to a printer.

All patients wishing to register over the age of 16 are to complete the forms listed below in full and return them to the surgery in person. We cannot accept forms from someone on behalf of another if they are over the age of 16. Forms for children 15 and under can be returned to the surgery without the child being present. Those over the age of 16 wishing to have access to online services will need to provide 1 form of photo ID at point of registration.

We ask that when returning forms, where possible, please return during the hours of 9am and 4pm when there are more staff on duty and receiving and checking of registration forms can be dealt with more quickly and thoroughly.

IT IS IMPORTANT THAT ALL FORMS ARE COMPLETED FULLY AND RETURNED ALTOGETHER.

PATIENT REGISTRATION AGED 16 AND OVER – PLEASE PRINT AND COMPLETE FORMS BELOW:

GMS1 Registration Form

New Patient Questionnaire - Over 16s

Alcohol AUDIT-C (PDF, 382KB)

Opt-Out Form

Online Access

PATIENT REGISTRATION FOR 15 AND UNDER PLEASE PRINT AND COMPLETE FORMS BELOW:

GMS1 Registration Form

New Patient Questionnaire - Under 16s

Opt-Out Form

If you move out of the area you will need to register with a new practice as soon as you move. We can provide information about how to find a new practice.

When registering patients the practice does not discriminate on the grounds of race, gender, social class, age, religion, sexual orientation, appearance, disability of medical condition.

An interpreter system is available on request.

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Wickham Park Surgery

2 Manor Road, West Wickham, Kent, BR4 9PS

  • 020 8777 1293
  • selicb.wickhamparksurgery@nhs.net
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Local Services
Ever thought about fostering? Could you give a local child a secure and loving home? Contact a local fostering agency today Ever thought about fostering? Could you give a local child a secure and loving home? Contact a local fostering agency today Ever thought about fostering? Could you give a local child a secure and loving home? Contact a local fostering agency today Fostering For You Fostering For You
Protect your family against future cost and save money. Organise a prepaid funeral plan today J & R Killick