New Patient Registration
New Patient Registration
You can be registered at the University of Warwick Health Centre if:
- You are a current student of the University of Warwick
- You are an Undergraduate living on Campus, within the catchment Area or in Kenilworth or Leamington
- You are a Postgraduate living on Campus or within the catchment Area
- You are a member of University staff living on Campus
If you registered last year you do not need to register again
You will only be registered after you have completed ALL of the required forms.
New Patients Only
You will need to register with the Health Centre as part of your enrolment.
Students or members of staff with children need to register at the Health Centre. Please provide identification (Passport) and full immunisation history in English.
You will be informed the practice you are registered with on your first contact with the Health Centre. Please do not ring or visit to ask for this information.
IMPORTANT INFORMATION - BRITISH STUDENTS
YOU CAN SUBMIT YOUR REGISTRATION FORM AS PART OF YOUR ENROLMENT FROM AUGUST 2019. SO YOU REMAIN REGISTERED WITH YOUR HOME GP WE WILL NOT START TO PROCESS FORMS UNTIL THE 9TH SEPTEMBER 2019.
IMPORTANT INFORMATION - ALL STUDENTS
IF YOU DO NOT REGISTER WITH THE HEALTH CENTRE YOU WILL NOT BE ABLE TO USE OUR SERVICES UNLESS YOU HAVE A SERIOUS MEDICAL EMERGENCY
The General Data Protection Regulation was introduced on 25th May 2018. As a result, we are publishing a new Privacy Notice to make it easier for you to find out how we use and protect your information and it is here
DO NOT USE THIS FORM TO CHANGE YOUR ADDRESS
INSTRUCTIONS FOR COMPLETING FORM
Please complete the form ONLINE form as shown below:
Patient Declaration - for all patients who are not ordinarily resident in the UK. Anybody in England can register with a GP practice and receive free medical care from that practice. However, if you are not ‘ordinarily resident` in the UK you may have to pay for NHS treatment outside of the GP practice. Being ordinarily resident broadly means living lawfully in the UK on a properly settled basis for the time being. In most cases, nationals of countries outside the European Economic Area must also have the status of ‘indefinite leave to remain` in the UK.Some services, such as diagnostic tests of suspected infectious diseases and any treatment of those diseases are free of charge to all people, while some groups who are not ordinarily resident here are exempt from all treatment charges.More information on ordinarily residence, exemptions and paying for NHS services can be found in the Visitor and Migrant patient leaflet, available form you GP Practice.
Being ordinarily resident broadly means living lawfully in the UK on a properly settled basis for the time being. In most cases, nationals of countries outside the European Economic Area must also have the status of ‘indefinite leave to remain` in the UK.
Some services, such as diagnostic tests of suspected infectious diseases and any treatment of those diseases are free of charge to all people, while some groups who are not ordinarily resident here are exempt from all treatment charges.
More information on ordinarily residence, exemptions and paying for NHS services can be found in the Visitor and Migrant patient leaflet, available form you GP Practice.
You may be asked to provide proof of entitlement in order to receive free NHS treatment outside of the GP practice, otherwise you may be charged for your treatment. Even if you have to pay for a service, you will always be provided with any immediately necessary or urgent treatment, regardless of advance payment.
The information you give on this form will be used to assist in identifying your chargeable status, and may be shared, including with NHS secondary care organisations (e.g. hospitals) and NHS Digital, for the purposes of validation, invoicing and cost recovery. You may be contacted on behalf of the NHS to confirm any details you have provided.
A parent/ guardian should complete the form on behalf of a child under 16.
I declare that the information I give on this form is correct and complete. I understand that is is not correct, appropriate action may be taken against me.
Complete this section if you live in another EEA country, or have moved to the UK to study or retire, or if you live in the UK but work in another EEA member state. Do not complete this section is you have an EHIC issued by the UK.
If yes, please complete the following:
Please note we will record the above information and add an alert message
Summary Care Record
A Summary Care Record is an electronic record which contains information about the medicines you take, allergies you suffer from and any bad reactions to medicines you have had. This information makes it easier for health care staff to treat you in an emergency or when your GP practice is closed.
We offer free HIV Tests (Ask at reception for more information)
FAST ALCOHOL SCREENING TEST
For the following questions – 1 standard drink = 1 unit of alcohol
An indication of a standard drink is as follows:
Half pint of regular beer, larger or cider.
Small glass of wine
Single measure of spirit
Single measure of aperitifs
Only answer the following questions if the answer above is Never (0), Monthly (1) or Less than monthly (2). Stop here if the answer is Weekly (3) or Daily (4).
Please type your total score below based on the answered provided in the FAST ALCOHOL SCREENING TEST
ALL QUESTIONS MARKED * ARE MANDATORY
Information submitted through secure forms is used only for the purposes of processing your request. We may
be in touch with you in relation to the information submitted.
All Information submitted through secure forms is secured with a private key known only to the GP practice and is
accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.
This information is not shared with any third party organisations.
This information is retained for up to 28 days.
Should you have any concerns about sending your personal details using the web,
please use one of the alternative methods offered by our organisation.