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Frankley Health Centre
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New Patient Registration Form
New Patient Registration Form
— New Patient Registration – England – 01
Preliminary Questions
Is this your first registration with a GP Practice in the UK?
*
Yes
No
Are you from abroad?
*
Yes
No
Were you ever registered with an Armed Forces GP?
Yes
No
Do you need your doctor to dispense medicines and appliances?
Yes
No
Are you ‘ordinarily resident’ in the UK?
*
Yes
No
If you are human, leave this field blank.
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