GMS1 form

GMS1

Please complete both the GMS1 form and relevant new patient questionnaire in full for each person applying to register in order for your application to be accepted. 

Registeration
Name
Name
First
Last
Please use this date format: DD/MM/YYYY.
Previous Name
Previous Name
First
Last
Gender
Please use this date format: DD/MM/YYYY.
Please use this date format: DD/MM/YYYY.
Please use this date format: DD/MM/YYYY

If you are registering a child under 5


If you need your doctor to dispense medicines and appliances*

*Not all doctors are authorised to dispence medicines

NHS Organ Donor registration

For more information, please ask at reception for an information leaflet or visit the website www.uktransplant.org.uk, or call 0300 123 23 23.

 

NHS Blood Donor registration

For more information, please ask for the leaflet on joining the NHS Blood Donor Register

 

European Economic Area (EEA) Country

For a list of EEA countries visit: www.gov.uk/eu-eea

 

Supplementary Questions