New Patient Registration

We are currently accepting new patients, who live in the Billericay area. 

To register at Billericay Medical Practice please complete the following forms.

Please note that you need to send a copy of your photo ID and 1 proof of address, dated within the last 3 months (this can be a utility bill or letter). For under 16's who do not have a photo ID, please include a copy of their birth certificate. 

For new born babies only the GMS1 Registration Form needs to be completed.

Adults and children need to complete BOTH the GMS1 Registration Form and the Registration Pack.

GMS1 Registration Form 

New Patient Registration Pack

Please email the completed forms with a photo of your photo ID and proof of address to or put the forms and copies of your documents in the white post box on the front of the building. 

Please allow 2 full working days for your application to be processed. 

We can only register patients who are living in the Billericay area, if you are unsure if you are within our catchment area, please check with reception on 01277 658071. 

Third Party Consent

In order to allow a family member to speak to the surgery on your behalf, which would include regarding any appointments, medical history, test results or any other clinical or non clinical information, please complete and sign the below Third Party Consent Form. The form must be signed by the patient who is giving consent. 

Third Party Consent Form

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