Register for online services

Required fields are labelled

What is your name?

First name

Last name

What is your date of birth?

For example, 31 3 1980

Day

Month

Year

What is your sex?

As recorded on your medical record

Male

Female

Other

What is your postcode?

The one used to register with your GP

What is your phone number?

What is your email address?

Anyone else with access to your email account may see responses sent to you

Address, including postcode:

Things to Consider before applying for online services

Please read the important information on our Registering for Online Services page before completing the form.

Before you apply for online access to your record there are some other things to consider. Please visit our Things to Consider When Applying for Online Access page.

I wish to have access to the following online services (tick all that apply):

Booking appointments

Requesting repeat prescriptions

I wish to have online access to my medical record