New Patient Registration

The Black Country Family Practice is open to new patients.

If you live in our area (see below) and would like to register with us, please complete one of our registration forms that are available from reception. You will be registering with the practice rather than an individual GP.

You can fill out the on-line pre-registration form. Please click "Pre-registration" in the tab above.

Please bring along any regular medication that you are taking. We will not be able to prepare a repeat prescription immediately, so please ensure you order any repeat medication from your old surgery to avoid running out.

Practice Area

The Black Country Family Practice registers patients from Tipton and parts of Dudley and Wolverhampton. If you would like to register with our practice, please ask a member of the practice team if your address falls into our area.

Non-English Speakers

These fact sheets have been written to explain the role of UK health services, the National Health Service (NHS), to newly-arrived individuals seeking asylum. They cover issues such as the role of GPs, their function as gatekeepers to the health services, how to register and how to access emergency services.

Special care has been taken to ensure that information is given in clear language, and the content and style has been tested with user groups.

Open the leaflets in one of the following languages

English	Urdu
Albanian	Hindi
Arabic	Lithuanian
Bulgarian	Polish
Chinese (Cantonese)	Portuguese
Chinese (Mandarin)	Spanish
Russian	French
Turkish	Punjabi
Gujerati	Somali
Croatian	Bengali

Pre-registration with the practice

If you wish to pre-register click on the link below to open the form. When you have completed all of the details, click on the "Send" button to mail your form to us. When you visit the surgery for the first time you will be asked to sign the form to confirm that the details are correct.

Pre-registration Form

When you register you will also be asked to fill out a medical questionnaire. This is because it can take a considerable time for us to receive your medical records. There is an online version of this file too, which you may fill out and send to us. When you come to the surgery you will be asked to sign this form to confirm that the details are correct.

Online medical questionnaire for new patients

Note that by sending the form you will be transmitting information about your self across the Internet and although every effort is made to keep this information secure, no guarantee can be offered in this respect.

Registration Form