New Patient Registration Form & Health Questionnaire

Quote / Testimonial:

Our mission is to provide an excellent experience of high-quality healthcare.

The practice aims to give its patients high quality care in a secure environment. Whilst you are in our care or visiting our premises you have the right to expect courtesy and consideration from our staff and from other patients and visitors, and they have the right to expect the same courtesy and consideration from you.

Code of behaviour for patients & visitors

Dear patient,

There are seven key principles that guide the NHS in all it does:

  1. The NHS provides a comprehensive service, available to all
  2. Access to NHS services is based on clinical need, not an individual’s ability to pay
  3. The NHS aspires to the highest standards of excellence and professionalism
  4. The patient will be at the heart of everything the NHS does
  5. The NHS works across organisational boundaries
  6. The NHS is committed to providing best value for taxpayers’ money
  7. The NHS is accountable to the public, communities and patients that it serves

They are underpinned by core NHS values: working together for patients, respect and dignity, commitment to quality of care, compassion, improving lives & everyone counts.

We believe that the practice and patients both have rights and responsibilities to ensure a friendly, courteous and efficient service provided under a safe environment. Below are some responsibilities that patients and the practice should always follow.

Patients and the public – your responsibilities the NHS belongs to all of us. There are things that we can all do for ourselves
And for one another to help it work effectively, and to ensure resources are used responsibly

  1. Please recognise that you can make a significant contribution to your own, and your family’s, good health and wellbeing, and take personal responsibility for it.
  2. Treat NHS staff and other patients with respect and recognise that violence, or the causing of nuisance or disturbance on NHS premises, could result in prosecution. You should recognise that abusive and violent behaviour could result in you being refused access to NHS services.
  3. Provide accurate information about your health, condition and status. Please keep appointments or cancel within reasonable time. Receiving treatment within the maximum waiting times may be compromised unless you do.
  4. Follow the course of treatment which you have agreed and talk to your clinician if you find this difficult.
  5. Participate in important public health programmes such as vaccination.
  6. Ensure that those closest to you are aware of your wishes about organ donation.

You have the right to explanations of your illness and any investigations relevant to that illness. If you require referral to a specialist you will be offered a choice, in accordance with the NHS ‘Choice and Booking’ agenda.

– You should treat ALL practice staff and other patients with courtesy and respect at all times.

– As this is a busy practice, please be patient if the Clinician is running late. If you arrive up to 10 minutes late for your appointment, we will endeavour to retain your appointment slot and send you in to see the Doctor/Nurse as soon as possible, you may have to wait if others patients attend on time for their appointments.

– If you arrive more than 10 minutes late for your appointment your turn may be lost you will have to rebook your appointment.

– All repeat medication should be ordered within a MONTH prior to medication running out. Please allow THREE COMPLETE WORKING DAYS before collecting the prescription. Repeat medication will only be issued when due, in accordance with dose indicated by your clinician.

– Please ensure a single appointment is for ONE person and ONE problem only. If you have more than one medical problem, please request a longer appointment.

– Please note that the first seven days of any sickness a self-certificate is sufficient. However, if requested a private certificate may be issued and appropriate fee charged.

– All Non-NHS services will incur charges depending on the service requested, please confirm the agreed fee with staff before proceeding with your request. Any private report etc. is provided on the basis of your medical conditions and fees are charged in respect of time spent preparing such reports, therefore fees are non-refundable.

– Talk to us about complaints, suggestions and feedback. We are always looking to develop and support out patients.

– We aim to treat all patients and staff with respect and courtesy, irrespective of his/her ethnic origin, religious beliefs, personal attributes, or the nature of health problem

– We will maintain your right to privacy and confidentiality and will not discuss your illness with other staff members on an unprofessional basis.

– Help you make an informed decision about your health and advice on treatment in a timely manner

– Keep up to date with the developments in the community and in line with our local CCG’s aim and objectives

– Treat you with compassion and dignity at all times

– Appointments options include Face to face, video and telephone consultation. We offer 24/7 Online consultation via Accurx via our website

– Receptive to feedback both positive and negative – about your experiences and the treatment and care you have received, including any adverse reactions you may have had. You can often provide feedback anonymously and giving feedback will not affect adversely your care or how you are treated. If a family member or someone you are a carer for is a patient and unable to provide feedback, you are encouraged to give feedback about their experiences on their behalf. Feedback will help to improve services for all.

We operate on a zero tolerance policy to abuse in the NHS. Patients who display unacceptable behaviour or violence towards staff or other patients will be removed from the list in line with NHS England guidance on acceptable behaviour.