ICO Health Group

Register for Online Services

Please complete this form to begin the process to register for online services. Before we can complete the registration process we will need to see two forms of identification. One of these I.D. items must include your photograph.

You will then receive your own unique username and password.

Once you are registered you will be able to use the service to:

Order repeat prescriptions
Make appointments
Cancel an appointment
Update your contact details
Review your medications and known allergies

For further information about online services please visit the NHS Choices website.

First Name *

Last Name *

Email *

Enter Email

Confirm Email *

Confirm Email

Date of birth *

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

Phone Number *

Address *

Address

Town/City

County

Postcode

Country

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.

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