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The Nelson Medical Practice

Kingston Road, London, SW20 8DA

111 Out of hours
GP services only, call: 020 3826 0826
All other Health Centre Services, call: 0203 668 3300

Nelson Medical Practice

Adult New Patient Registration form (NEW)

NHSFamily doctor services registrationGMS1

Personal Details

Please use this date format: DD/MM/YYYY.
(Note: If you are age 45 or over please take your blood pressure reading on one of our machines and inform our Patient Care Navigators of your result. Please let us know if you require any assistance with this)
Any responses we send will go to this email address.

Next of Kin

We recommend that you register for on-line access. To do this please Google ‘Patient Access’ or alternatively follow the registration link on our website: https://www.nelsonmedicalpractice.co.uk/online-services/

Before registering on-line please allow 5 working days for your practice registration to be completed.

Medication

Please give details of any medication which you take (prescribed or otherwise)

EPS - Electronic Prescribing Service

Allergies

Past Medical History

Smoking

The health benefits of stopping smoking are well known and we would advise all our patients to stop smoking. If you would like help stopping smoking you can contact the One You Merton Stop Smoking Service on 0208 973 3545.

Height/Weight

Women Only

Alcohol

This is your total score from the Alcohol Consumption section.
A total of 5 or more indicates possible higher risk drinking. If you have a total score of 5 or more please complete the drinking questionnaire below.
If you score higher than 8 you will be offered brief advice on drinking.
If you have score 8 or more please complete the PHQ9 questionnaire below.

0-7 = sensible drinking, 8-15 = hazardous drinking, 16-19 = harmful drinking and 20+ = possible dependence

This is one unit of alcohol:

And each one of these, is more than one unit:

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