All patients registering at Mere Surgery will be allocated a named General Practitioner depending on their surname.
Patients with a surname beginning with A-K will be allocated under Dr Halsey and patients with a surname beginning with L-Z will be allocated under Dr King.
Patients are however free to see any doctor of their choice for each consultation although we would encourage you to see the same doctor for the duration of each problem to ensure continuity of care.
If registering a child under 5:
Previous Address Details
Has this child ever been registered with a GP in the UK?
Child’s Previous address in UK:
Please include postcode.
Name and address of previous GP:
If you are from abroad
Child’s first UK home address when registered with a GP:
Does the child have any allergies?
Please specify what they are allergic to, what happens and when they had their first reaction:
Type of Birth if under 5 ( Normal, Forceps, Caesarean)
Birth Weight if under 5:
Feeding if under 5 (Breast or Bottlefed):
Does the child take regular medication?
Does the child have any long-term illness, health problem or disability?
Please make an appointment for a new patient health check.
Are there any serious diseases that affect the child’s parents, brothers or sisters. Tick all that apply.
Any other important family illnesses:
Please state the family member to which illness relates to:
Child’s main spoken language (one only):
Does the child have any problems reading English? (school age children only)
Does the child have any problems speaking English?
If English is not the child’s main spoken language or yours, do they or you need an interpreter (someone to help with language) when they visit the doctor?
Child’s Immunisation History
Please give details of any immunisations this child has received and the date given and the clinic where given:
Please include dates.
Brother/Sisters/Siblings (Please give details of Name and Date of Birth):
Data Sharing Consent Choices
To maintain continuity of clinical care, we upload certain medical information so that it is available to other healthcare organisations (eg Emergency Departments).
Details of how we share your information are found in the
Privacy Notice available on our website or ask reception for a copy.
If you wish to opt out information is available at
www.nhs.uk or ask at reception.
Where you have provided information on how to contact you, can you confirm you are happy for Mere Surgery to contact you by the following:
By SMS text messaging:
Reminders for appointments, invitations to book into clinics and updating information about the surgery.
Summary Care Records (SCR)
These are an electronic record of important patient information, created from GP medical records. They can be seen and used bu authorised staff only; in other areas of the health and care system involved in the patients care.
To Opt Out, visit
NHS Organ Donor registration
To help complete your registration, please upload proof of identity, this should include photographic ID, proof of address and an image of you.