Register for online services

I understand that it is my responsibility to keep my account secure by keeping my details confidential. I understand that I can terminate my account at any time by contacting the surgery, or change my log in details by re-registering and that this form will be kept on my electronic records. I understand that my registration will be revoked if I constantly miss or cancel appointments.

I wish to have online access and understand and agree with each statement:

• I have read and understood the important information from the practice.
• I will be responsible for the security of the information that I see or download.
• If I choose to share my information with anyone else, this is at my own risk.
• I will contact the practice as soon as possible if I suspect that my account has been accessed by someone without my agreement.
• If I see information in my record that is not about me or is inaccurate, I will contact the practice as soon as possible.

Please bring photographic proof of your identification in order for the sign up process to be completed.