Child New Patient Registration (under 16 years)

If you would like to register with the practice please use this form.

To register a new patient you will need to live within our practice boundary.

New Patient Registration (Child under 16) - Kenneth MacRae

Patient's Details

Title *
Please use this date format: DD/MM/YYYY.
Sex: *
Any responses we send will go to this email address.
What is your preferred contact number? *
Can we contact you by text?
Can we contact you by email?
Can we leave you voicemail messages?

Parental Responsibility and Next of Kin

A child who is being looked after by their local authority is known as a child in care. They might be living: with foster parents, at home with their parents under the supervision of social services or in residential children's homes.

Is the child a looked after child? *
Under what arrangement?
Parental Responsibility:


Please specify the child's ethnic group:
Do you need an interpreter? *


What is your religion?

Previous Details

Does the child have a previous UK address? *
Please include postcode.
Is the child currently registered with another GP? *

If the child is from abroad

Registering with the NHS for the first time in the UK
Please use this date format: DD/MM/YYYY.

If the child is returning from abroad

Previously been registered with the NHS in the UK
Please use this date format: DD/MM/YYYY.
Please use this date format: DD/MM/YYYY.


A carer is a friend or family member who gives their time to support a person in their home, to an extent that the person could not remain at home if this care was not being provided. A carer can receive Carers Allowance, but not a wage and the care they are giving will significantly affect their own life.

Does the child look after or support someone who couldn’t manage without them?
Do they look after someone who is a patient at the practice?
Are they a: