Translate

Temporary Registration

Page {{ paginatorProps.current }} of {{ paginatorProps.total }} ({{ paginatorProps.percentage }}% completed)

All questions marked with a * are mandatory

Temporary Patient Registration

If you are currently staying within our practice boundary and need urgent medical care

Please contact your registered GP in the first instance to see whether they can continue to support you remotely e.g. by sending a prescription for your medication to one of our local pharmacies.
In most other cases, calling 111 is a better option.
If you need to see a doctor, you can register at the practice as a temporary resident by completing this form.

Find out more about the process by visiting the NHS Website

Processing

Patient Details

Title: *

Providing a NHS Number means that we can find a patient record more accurately, saving time and resources.

Do you have a temporary address?: *

Processing

Your Usual Doctors Details

All details of treatment will be sent to this doctor and address.

Processing

This form collects personal and medical information about you and we use this information to allow the practice team to contact you.
Please read our Privacy Policy to discover how we protect and manage your submitted data.

Processing

There appears to be a problem loading the form, please refresh the page.
If the error persists please contact us.

Providing NHS Services

Fernbank Surgery
Lytham Primary Care Centre
Victoria Street, Lytham
FY8 5DZ

Freckleton Health Centre
Douglas Drive, Freckleton
Lancashire, PR4 1RY

Telephone: 01253 202040