Please Note
We are not accepting transfers within Waterford city area, and we are only accepting patients new to Waterford City that do not have a GP. We only accept new patients within the Waterford city catchment area.
In order to provide for your care we need to collect and keep information about you and your health in your personal medical record. Please complete the following form carefully. The information will be used to create your personal medical record on the practice computer.
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Our practices are consistent with the Medical Council guidelines and the privacy principles of the Data Protection Acts. For further details please see our Privacy Statement.
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Submitting this form does not guarantee acceptance to the practice. A member of our team will contact you as soon as possible to advise if we currently have space on our list. If you are accepted as a new patient and have a chronic medical condition or take regular medications, we request that you arrange a registration consultation with a GP.
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​Please note that adults must complete their own separate form to register, however children can be included on a parent's application.
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If you would prefer to submit the form in writing, please contact reception for a form.
Proof of ID & Address
To complete your registration, we require proof of ID and proof of address. These documents are collected solely for the purpose of verifying your eligibility to register with the practice.
Your information will be stored securely until your registration is processed. After this point, it will either be saved to your patient file (if applicable) or permanently deleted, in line with the practice’s data retention policy.
The practice would like to contact you by text message (SMS) regarding appointment reminders, test results and practice updates.
By submitting this form you will be sending personal/sensitive information about yourself across the Internet. Please read our privacy statement​ to discover how we protect and manage your submitted data. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method of contacting the practice.
