Minors New Patient Registration (Under 11s)

Last Updated: 25/07/2023

  • Personal details

    Sex at birth
    Date of birth
    For example, 15 3 1984

  • Previous medical records

    Please help us trace your previous medical records by providing the following:

  • IF YOU ARE FROM ABROAD

    Please note, we are unable to process your registration if you do not put a date of entry into the UK

    Date you first came to live in the UK (optional)
    For example, 15 3 1984

  • Parents/Guardians details

    Do you have parental responsibility? (optional)
    Do you have parental responsibility? (optional)

  • Medical Information

  • Routine childhood immunisations

    PLEASE NOTE: If you do not complete the immunisation section, you may be contacted before we can complete the registration.

     

    Usually given around 2 months

    1st DTaP/IPV/HIB (Diphtheria, tetanus, pertussis, polio and Hib (optional)
    For example, 15 3 1984
    Hepatitis B (optional)
    For example, 15 3 1984
    MEN B (Meningococcal B) (optional)
    For example, 15 3 1984
    Rotavirus (optional)
    For example, 15 3 1984
    PCV (Pneumococcal) (optional)
    For example, 15 3 1984

  • Routine childhood immunisations

    Usually given around 3 months

    2nd DTAP/IPV/HIB (Diphtheria, tetanus, pertussis, polio and HIB) (optional)
    For example, 15 3 1984
    PCV (Pneumococcal) (optional)
    For example, 15 3 1984
    Hepatitis B (optional)
    For example, 15 3 1984
    Rotavirus (optional)
    For example, 15 3 1984

  • Routine childhood immunisations

    Usually given around 4 months

    3rd DTAP/IPV/HIB (Diphtheria, tetanus, pertussis, polio and hib) (optional)
    For example, 15 3 1984
    Hepatitis B (optional)
    For example, 15 3 1984
    Men B (meningococcal B) (optional)
    For example, 15 3 1984
    PCV (Pneumococcal) (optional)
    For example, 15 3 1984

  • Routine childhood immunisations

    Usually given around 12 - 13 months

    HIB/MEN C (optional)
    For example, 15 3 1984
    1st MMR (measles, mumps and rubella) (optional)
    For example, 15 3 1984
    PCV (pneumococcal booster) (optional)
    For example, 15 3 1984
    Men B (meningococcal B) (optional)
    For example, 15 3 1984

  • Routine childhood immunisations

    2nd MMR (measles, mumps and rubella) (optional)
    For example, 15 3 1984

  • Routine childhood immunisations

    Usually given around 3 yrs 4 months

    4th Pre school booster dtap/ipv (diphtheria, tetanus, pertussis and polio) (optional)
    For example, 15 3 1984

  • Non-routine vaccines

    BCG (optional)
    For example, 15 3 1984
    Meningitis C (optional)
    For example, 15 3 1984
    hib booster (haemophilus influenza B) (optional)
    For example, 15 3 1984

  • Immunisation schedule

    Are you following the UK immunisation schedule?

  • Ethnic group

    Ethnic group

  • Summary Care Record

    Summary Care Record (SCR) – used nationally across England

    The SCR is a national database intended to help patient care, particularly in emergencies.  It contains registration details (name, address, date of birth, NHS number etc) and a list of prescribed medication and allergies.  It is useful for an Accident & Emergency department to check for allergies or drug interactions, to improve the treatment they can provide for you.  It is also possible to ask for a more detailed SCR containing significant diagnoses, referrals, vaccinations, care plans or other details.  Your permission will be checked each time, unless there is a special factor such as being unconscious or otherwise unable to consent.  For further information see https://digital.nhs.uk/services/summary-care-records-scr

    Summary care record

  • Oxfordshire Summary Care

    The Oxfordshire Care Summary and the Out – Hours GP records sharing system

    Your patient record is held securely and confidentially on an electronic system controlled by your GP Surgery.  Your information can be viewed if you need treatment in another NHS healthcare setting, such as an Emergency Department, Out of Hours, GP, Minor Injury Unit or College Nurse (if applicable).  The professionals treating you can give you safer care if medical information from your GP Surgery is available to them.  In all these cases, your information will be viewed only by authorised healthcare professionals directly involved in your care.  You will be asked permission before the information is accessed unless the health professional is unable to ask you and there is an important clinical reason for accessing it.

    Please select one option below

  • If you are registering a child under 5 yrs

    I wish the child above to be registered with the named doctor for Child Health Surveillance (optional)

  • Signature

    Relationship to patient
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