New Patient Registration

Each new patient wishing to register with Brackley Medical Centre needs to complete a Registration Form GMS1 plus a New Patient Questionnaire (there is a different questionnaire for adults and for those under the age of 16). These can be downloaded below. Once completed, you will need to bring the forms into the surgery in person together with relevant identification (see New Patient Documentation )

 New Patient Questionnaire - Adult

 New Patient Questionnaire - Under 16 yrs.

 New Patient Documentation

Please also complete a GMS1 Form ( see link below ) for each person registering at our Practice.

Registration Form GMS1 

Disabled Access

Wheelchair access to Washington House is through either the main door or the side access. A disabled patients’ WC is provided just off the front waiting room. Reception staff will be pleased to give any assistance required. A wheelchair is also available on request at reception.

Change of Contact or Personal Details

Please advise reception if you change your name, address or telephone number. 

It would be a great help if you could also ensure that we have your postcode and your mobile number. 

If you have changed your name on marriage, we will need to see your original marriage certificate and will need to take a copy.

You can advise of these changes:  

  1. In writing or
  2. Completing a form which can be collected from Reception.

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