Family doctor services registration (GMS1)

Please note there are two completely separate practices working at Southwell house. To join The Puzey Family Practice please go to Windows 2 or 3 to complete the necessary forms. The receptionist will help you and will arrange a convenient time for your introductory medical examination. You will receive your new medical card through the post from Essex Health Authority after a few weeks but you will be entitled to medical care from the day you register with us. If you have any questions to ask about our practice or its services, feel free to ring us on 01702 533740 and speak to one of our receptionists or the practice manager.

Online Registration

To register online please complete the form below -

Patient’s details


Please provide in the format dd/mm/yyyy
If you know your NHS Number, please provide it


Please help us trace your previous medical records by providing the following information

If you are from abroad

If you are returning from the Armed Forces

If registering a Child under 5

If you need your doctor to dispense medicines & appliances

Not all doctors are authorised to dispense medicines

NHS Organ Donation registration


For more information, please ask at reception for an information leaflet or visit the website www.uktransplant.org.uk,
or call 0300 123 23 23.

NHS Blood Donor Registration


For more information, please ask for the leaflet on joining the NHS Blood Donor Register.

9 Confirm

Although sending information across the Internet means that privacy of data cannot be absolutely guaranteed, our online forms offer high levels of security. The forms use HTTPS and TLS (using a 2048 bit certificate) to encrypt data sent to and from your computer when using the site and our server environment is PCI DSS certified - the highest standard of security associated with e-commerce and online finance solutions.

Form submissions are stored on the server for 28 days and are encrypted and secured with a private key known only by the GP Practice.

Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

Your Neighbourhood Professionals Achilles Footcare
© Neighbourhood Direct Ltd 2017
Windows 2 and 3, Southwell House, Back Lane, ROCHFORD, Essex, SS4 1AY
  • Telephone 01702 533740
Practice Website supplied by Oldroyd Publishing Group
Your Neighbourhood Professionals Achilles Footcare
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