Thank you for considering registering with our practice.
You can now register with the practice online, which is our preferred method too.
PLEASE COMPLETE ALL STEPS BELOW (1,2 AND 3) OTHERWISE WE WILL NOT BE ABLE TO FINISH YOUR REGISTRATION.
Step 1: Check if you live in our catchment area to avoid disappointment
We can only register patients who currently live within the Borough of Ealing (postcode W3/W4/W5).
Check now if your postcode is within our catchment area.
Step 2: Complete online registration form
To register with our practice please follow the link below to complete the online registration form and patient information details.
- Click Link: Adult (over 16yrs old) New Patient Registration Form – Chiswick Family Practice
- Click Link: Child (under 16yrs old) New Patient Registration Form – Chiswick Family Practice
Step 3: Email us a copy of your photo ID + proof of address + your signature to:
- 1 Form of Acceptable photo ID (Acceptable Identification: Photo Driving License, Passport – if not possible, please let us know)
- 1 Form of Proof of Address (Tenancy agreement, Mortgage statement, Bank statement, Utility bill (date within the past 3 months) etc.
- Your Signature (can be digital – scan/photo of your handwritten signature) to confirm you wish to register with the practice (this is a current NHS England requirement)
- For children under 16 years of age, parents/ guardians should aim to provide a copy of Birth certificate and Immunisation record (in English).
We aim to register you as quickly as possible and within 10 working days. We will send you an email confirming you have been registered.
Once registered, you can seek help/advice using our practice website e-consult option.
Disabled Patients: Once registered, you will be able to telephone the practice from outside on arrival if you require any assistance in accessing the building or its services.