This website uses cookies to function correctly.
You may delete cookies at any time but doing so may result in some parts of the site not working correctly.

New Patient Registration


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

Registration form for under 18 yr old only

New Patient Health Check

GMS1 family doctor services registration form

Summary Care Records


Smoking Status

Electronic Prescribing

Patient Agreement

Alcohol Screening

Please complete all of the above forms otherwise this may hold up your registration.

You will also need to send a photo of two utility bills within the last 6 months showing the address that you are now living at in Billericay.

Please email the completed forms with a photo of your two utility bills to

Please allow 48 hours for your application to be processed


Please note that if you are currently on repeat medication you will need to nominate a chemist of your choice for your prescription to be sent to electronically.

It is not currently possible for you to collect your prescription from the surgery

Call 111 when you need medical help fast but it’s not a 999 emergencyNHS ChoicesThis site is brought to you by My Surgery Website