Online Registration Forms
If you wish to register with Emperor's Gate Surgery please complete and submit the registration forms below by emailing it to firstname.lastname@example.org along with a copy of photo ID, proof of address and proof of status in the UK.
Please fill out the following 2 forms:
* Registration Form (Adults)/Registration Form (Child)
* Summary care record form
To avoid delay in processing your registration, please ensure you provide all information required.
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.