Registration 2018-06-15T07:01:05-04:00

Please complete the registration form below.

We will confirm back with your appointment time.

We understand how important it is to keep your personal information safe and secure. Please see our Privacy Notice issued as part of our GDPR compliance.

Thanks for booking with us.

Registration Form

  • Patient Information

  • Date Format: DD slash MM slash YYYY
  • 1st Parent Information

    For patients under 16 only
  • 2nd Parent Information

    For patients under 16 only
  • Medical History*

  • Type n/a if none
  • GP Details*

  • This field is for validation purposes and should be left unchanged.

The clinic is now closed, and we are not currently making any new appointments.

Current patients can reach us by email for follow-up at

Thank you.