New Patient Registration

If you would like to register with the practice please use this form.

To register a new patient you will need to live within our practice boundary.

New Patient Registration

Patient's Details

Are you a student at the University of Gloucestershire? *
All University students who are living in Cheltenham are eligible for registration at the Underwood Surgery, which includes the use of the Medical Centre at the Park Campus.
Have you ever registered with the Underwood Surgery/University Medical Centre (previously CGCHE) before? *
Title *
Please use this date format: DD/MM/YYYY.
Gender *
This is not your NI number. It will be on your NHS Card or any hospital letters. If in doubt, please ask your current GP.
Any responses we send will go to this email address.
We may use your mobile number to text you regarding appointments, test results, etc. Would you like us to be able to contact you this way?
Can we contact you by email?
I wish to have access to the following online services (please select all that apply):


Please specify the ethnic group you consider you belong to: *
Do you speak English?
Do you read English?

Previous Details

Please include postcode.

If you are from abroad:

Registering with the NHS for the first time in the UK.
Please use this date format: DD/MM/YYYY.
Have you have ever been registered with a doctor in the UK?
Please use this date format: DD/MM/YYYY.
Please include postcode.

If you are returning from the Armed Forces

Have you ever been registered with an Armed Forces' GP as:
Do you have any immediate family members currently working in the Armed Forces?
Have you been registered with a Ministry of Defence GP in the UK or overseas?


Do you have a carer?
Are you a carer for someone?
Do you give us permission to discuss your medical record with your carer?