How to Register

PreRegistrationIf you wish to register with the practice you need to fill out the below registration forms and return them to the surgery with proof of your address. At the bottom of the page is an example of how the registration form should be completed. We are not able to register you with the practice until the form is filled out correctly. 

Some examples of proof of address accepted by the practice are:

  • Utility Bills
  • Council Tax
  • Tenancy Agreement

In order to register you we ask that you 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 form too, which you may fill out and return to the surgery.

Please fill out one of each the below forms for every member of the household you wish to register with the practice.

All forms need to be completed, signed and returned to Pontprennau Medical Centre in order for you to be registered with the practice.

Registration Form

Example Registration Form

Health Questionnaire Over 16

Health Questionnaire Under 16

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