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Complete the form below to register for online services.
After registering, we'll send your login details. You may be asked to verify your identity before you can access your account.
What is your name?
Title
First name
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Last name
What is your NHS number?
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NHS number
What is your date of birth?
For example, 15 3 1984.
Day
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Phone number
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Select which online service you would like to have access to.
Booking appointments
Requesting repeat prescriptions
Accessing my medical record
For access to medical records
To access your medical records, you will need to understand and agree to all of the following statements.
I will be responsible for the security of the information that I see or download
If I choose to share my information with anyone else, this is at my own risk
I will contact the practice as soon as possible if I suspect that my account has been accessed by someone without my agreement
If I see information in my record that is not about me or is inaccurate, I will contact the practice as soon as possible
Privacy protection
Information submitted through this form is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.
I consent to my information being used for the purposes described above and wish to submit this online form to Giffard Drive Surgery.
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