WHMP Newborn Baby Patient Registration Form

Fields marked "REQUIRED" are compulsory. You should only send this form if you are sure that you are eligible to join this practice. Sending this form will NOT automatically register you with the surgery. Sending this form does NOT guarantee or even imply that you will be accepted onto the practice register.

Last Updated: 15/12/2022

Baby's Details

Parent and Guardian Details (1)

Parent and Guardian Details (2)

Ethnic Origin and Main Language Spoken

Baby's Medical Information

Repeat Medication

If your child is on any repeat medication, please submit an Engage Consult to speak to a GP or Clinical Pharmacist within six weeks of registering.

We are unable to prescribe repeat medication without an initial consultation. Please have a list of current medication with you during your consultation.

Summary Care Record and Oxfordshire Care Summary

All patients registered with a GP have a Summary Care Record (SCR), unless they have chosen not to have one. The information held in your Summary Care Record gives health and care professionals, away from your usual GP practice, access to information to provide you with safer care, reduce the risk of prescribing errors and improve your patient experience.

Your Summary Care Record contains basic information about allergies and medications and any reactions that you have had to medication in the past.

Patient Proxy Online Access Registration

Patient Access allows you proxy access to view some of your child's electronic medical record online and request repeat prescriptions.

In order to access your child's details online you will need to bring photographic ID and proof of address for you and your child to the practice.

Parent/Guardian Disclaimer

The information provided above is correct to the best of my knowledge.

I have read and understood the information enclosed and have indicated my consent preferences throughout this form.

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