Springfield Medical PracticeKeresley Green Medical CentreBennetts Road SouthCoventry, CV6 2FLTel: 024 76332628
If you wish to register at the surgery you will need to complete a online registration form or call in person to the practice to collect the forms which you can take away and complete at your leisure.
We will need the GMS 1 form, the New Patient Registration Questionnaire and the Alcohol Screening Questionnaire (2 pages).
The registration process can take some time so please avoid coming to the surgery at busy times. After 2pm is best.
All applications to register with us will be considered equally and without discrimination of any kind.
Our practice area mainly covers the CV6 postal code area and stretches as far as the Holyhead Road to the west of the surgery, Keresley Village to the north, Foleshill Road / Lockhurst Lane to the east and the Ring Road to the south.
If you wish to register with the practice you must complete both of the forms below.
If you are under 16 we can not process applications online. Please contact the practice to register.
Click on the links to open each form, when you have completed all of the details, click on the "Send" button to mail your form to us.
Online Medical Questionnaire For New Patients
We require you to fill out the medical questionnaire before your registration will be completed , as it may take a considerable amount of time for us to receive your medical records.
When you visit the surgery for the first time you will be asked to sign the form to confirm that the details are correct.
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.
Thank you for choosing to register with Springfield Medical Practice.
To complete your registration, we require that you collect the forms from the surgery and complete the GMS1 form, The New Patient Registration Questionnaire and two pages of the Alcohol Screening Questionnaire.
These forms take some time to complete so you may wish to take them away with you and collect the evidence that you need to register. Alternatively, you can complete the forms online .
When you have fully completed the forms and have the required evidence, please bring all the paperwork to the surgery between 2pm to 5pm from Monday to Friday. A Receptionist will check the paperwork to complete the registration process.
If you are unsure of your current blood pressure, we have a machine in reception that you can use, and the receptionist will be happy to assist you.
For Children who are Registering
We require information regarding childhood immunisations (In the UK this would be the red book that all children are issued with). If you have moved from outside the UK, then documentation of proof of immunisations is required.
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. It covers issues such as the role of GPs, their function as gatekeepers to the health services, how to register and how to access emergency services.
This leaflet is for you if you’re under 16. It explains that anyone who looks after your health has to keep information about you private. This may be doctors, nurses, pharmacists or other health workers.
Guide to Accessing Services for Young People