Coxhoe Medical Practice > Forms > Upload ID documents for registration

Upload ID documents for registration

To ensure we can provide certain online services:

you are required to confirm your registration and provide proof of your address and identity
your details will be held at the surgery for a limited period of time until confirmation has been obtained

IMPORTANT: Please deliver to the practice copies of two forms of your identity.

One form of identity must contain a photo of yourself and the other must provide evidence of your current address.

You can upload copies of your identity with the form below. If you prefer to submit your documents in person please speak to the reception team.

Please allow at least 48 hours (2 working days) before your registration will be complete and speak to the practice to confirm your registration.

File upload for NPR

First Name *

Last Name *

Email *

Date of birth *

Please use format day/month/year e.g. 12/05/1979

Telephone number for us to contact you *

Upload ID document *

Maximum file size: 10MB

We accept jpg, png and gif files, up to 10MB.

Upload evidence of address document *

Maximum file size: 10MB

We accept jpg, png and gif files, up to 10MB.

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

The internet is not a secure place, however, we have gone to great steps in making sure the information you submit to us is as secure as possible. We use SSL (Secure Socket Layer) certificates to encrypt the communication between your computer and our web server. If you are not completely happy to provide information via the internet please contact the practice directly.

Your consent *

I consent to the practice collecting and storing my data from this form.

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Upload ID documents for registration

To ensure we can provide certain online services:

Privacy Policy

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