Register for Online Services

To register for our online services you will need to complete this form and then visit Brookside Surgery (off Gipsy Lane), bringing  with you two forms of identification. One of these items should include your photograph and the other with your current address (utility & mobile phone bills NOT accepted).

Please allow 3 working days before bringing your ID in.

We will then issue you a username and password.

Once you are registered you will be able to use the service to:

  • Access your medical record
  • Order your repeat prescriptions
  • Make an appointment
  • Cancel an appointment
  • Review your medications and known allergies

Please note all patients over 11 years must register for online services in person. Proof of address can be in a parent’s name, however a passport or birth certificate will need to be seen for children up to the age of 16 years.

Register for Online Services

Please use this date format: DD/MM/YYYY.

I understand that I will have access to these online services.

  • Booking appointments
  • Requesting repeat prescriptions
  • Accessing my medical record

I wish to access my medical record online and understand and agree with each statement below.

  • I will ensure I understand the information provided by the practice when I supply my ID.
  • 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

Patient Representative

I am the patient’s representative, and I am registering on behalf of:

For Practice Use Only