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New Patients

How to Register 

If you live in our practice area you may apply to register. You will need to fill in a questionnaire and registration form and bring your medical card if you have it.

You will also need to attend for a new patient medical with the nurse.

Patients living outside of the practice area will only be registered at the discretion of the doctors.

Practice Area

Pre-Registration with the practice

If you wish to pre-register click here for the online form. When you have completed all of the details, click on the "Send" button to mail your form to us. When you visit the surgery for the first time you will be asked to sign the form to confirm that the details are correct.

Pre-registration Form

When you register you will also be asked to fill out a medical questionnaire. This is because it can take a considerable time for us to receive your medical records. Click here to download this form.  Please print out and return the form to the practice on your first visit.

Medical questionnaire for new patients (.pdf)

Alternatively you may print off a registration form, fill it out and bring it in with you on your first visit to the practice.

Registration Form (.pdf)


Your Neighbourhood Professionals Mark Ackers Fitness S N Electrical
© Neighbourhood Direct Ltd 2017
Buckshaw Village Health Centre, Unity Place, Buckshaw Village, Chorley, PR7 7HZ
  • Telephone 01772 214 444
Practice Website supplied by Oldroyd Publishing Group
Your Neighbourhood Professionals Mark Ackers Fitness S N Electrical
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