Botesdale Health Centre
Botesdale Health Centre Botesdale Diss Norfolk IP22 1DW
Tel: 01379 898295
Fax: 01379 890477
Out of Hours: 111

Registration Information

 

You can register with our Practice as long as your home address is within the Practice boundary - as shown below.

Patient Registration

On your first visit to the Health Centre, after completing the form below, you will need to sign your completed form and provide us with both Photo ID and Proof of Address.

NOTE: You can save your details and automatically populate this form by creating an account.
Click here to create an account or login.

Patient Registration Form

Patient Registration Form

Please complete the following form to register with us.

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  • Please help us trace your previous medical records by providing the following information

  • If you are from abroad

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  • If you are returning from the Armed Forces

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  • If you are registering a child under 5

  • If you need your doctor to dispense medicines and appliances*

    * Not all doctors are authorised to dispense medicines

  • NHS Organ Donation registration

  • NHS Blood Donor Registration

  • Summary Care Record

    A Summary Care Record is an electronic record which contains information about the medicines you take, allergies you suffer from and any bad reactions to medicines you have had.

    Having this information stored in one place makes it easier for healthcare staff to treat you in an emergency, or when your GP practice is closed.

    Click here for a leaflet containing more information.

  • Captcha

    This helps to prove you are human and not a robot.

NOTE: You can save your details and automatically populate this form by creating an account.
Click here to create an account or login.

New Patient Medical Questionnaire

New Patient Medical Questionnaire

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  • If you do not have a home telephone number please enter your main contact telephone number here instead.

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Update Your Contact Details

If you change your name, address or telephone number, please let us know. You can do this with the online form below.

If you move outside the Practice area, it will be necessary for you to find a Doctor in your new area.

If you are moving temporarily out of our practice area, you must sign on with a GP in your new area. We will be unable to provide medical services to you until you return to our practice area.

Please note: if you are under the care of a hospital when you change address, it is your responsibility to let them know that your details have changed.

NOTE: You can save your details and automatically populate this form by creating an account.
Click here to create an account or login.

Update Your Contact Details

Update Your Contact Details

Please fill in the form below to update your contact details.

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  • If you do not have a home telephone number please enter your main contact telephone number here instead.

  • Other members of your family requiring a change of address (if registered here)

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Sign Up For Text Message Reminders

Here at Botesdale Health Centre we will be piloting a new SMS (Text Messaging) Appointment Reminder service later in the year.

Signing up to this new SMS Text Messaging Service means you will receive an appointment reminder when the appointment is first booked and then a further reminder 48hours before the appointment.

Please note this service is currently only available to Patients of the aged of 16 Years or over.
PLEASE HELP US TO HELP YOU by giving us your mobile number and consent by completing the SMS Text Messaging Consent Form available to download below or at the Reception desk. Please return this form to Reception.

SMS Text Messaging Consent Form

Temporary Residents

 

If you are staying in the area (for up to 3 months) and require access to health care we will ask you to register as a temporary patient. Please come into the Practice and ask for a Temporary Resident form and, once completed and signed, you are able to receive medical assistance straight away.