Register for Online Services Form

If you wish to register for online services please complete this form. You must produce your identification in person. Once this has been verified, we will issue you with the necessary documentation so you can then register for online services.

First Name *

Last Name *

Email *

Enter Email

Date of birth *

Please use format day/month/year e.g. 12/05/1979

Phone Number *

Address *

I wish to have access to the following online services *

Requesting repeat prescriptions

Please tick all that apply

Evidence of Identity

To register for Online Services we need to verify your identity. So, please provide the practice: One photo ID such as passport or drivers licence and one form of ID with your home address on such as a recent utility bill or bank statement.

These will need to be taken in to the practice so a member of staff can varify

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

I consent to the practice collecting and storing my data from this form.

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Underfunding of GP Practices by the Scottish Government.

Register for Online Services Form

Evidence of Identity

Privacy Policy