New Patient Registration

We welcome any new patient to the practice if you stay within our Practice area.

Registration forms can be filled out on this page.

New Patient

When joining the Practice, you will be asked to complete a short questionnaire asking about your medical history and current status.  These forms are available here and can be completed ahead along with the Registration Form.  Please complete both the questionnaire and the registration form and return to us via email

 Clinical_Practice_AyrFullartonPractice_80113@aapct.scot.nhs.uk

Registration Form (Digital Version)

Practice Registration Form

  • 1. PERSONAL DETAILS (ALL FIELDS MARKED * ARE MANDATORY AND MUST BE COMPLETED AS FULLY AS POSSIBLE

    (If ‘No’, please complete a temporary resident form)
  • DD slash MM slash YYYY
  • Community Health Index (CHI) NumberNHS Number 
  • Town of birthCountry of birthRegistered district of birth (Scotland only)Mother's maiden name 
  • the data supplied in these fields will not be input to, or updated in the Community Health Index but will be held on the GP's Practice's System
  • 2. HELP US TO TRACE YOUR PREVIOUS HEALTH RECORDS BY PROVIDING THE FOLLOWING INFORMATION

  • If you are from abroad:

  • DD slash MM slash YYYY
  • DD slash MM slash YYYY
  • If you have served in the British Armed Forces:

  • DD slash MM slash YYYY
  • DD slash MM slash YYYY
  • 3. VOLUNTARY AUTHORISATION FOR ORGAN OR TISSUE DONATION

    You have a choice about organ or tissue donation after your death. To find out more about why it is important that you take the time to make your donation decision and record it, go to www.organdonationscotland.org
  • 4. HOW WE USE YOUR INFORMATION

    The information you have provided will be used by NHS Scotland to carry out its various functions and services including scheduling appointments, ordering tests, hospital referrals and sending correspondence. Your information, including your name, gender, date of birth and address, will be passed to NHS National Services Scotland where it will be held on the Community Health Index (CHI). This information is used to register you with the GP Practice, transfer your medical records between GP practices in the UK, make payments to GP Practices for medical services provided, and to process and issue medical exemption certificates and entitlement cards. NHS National Services Scotland shares information about you within NHSScotland to assist in the provision and improvement of NHS services and the health of the public. When we do this, we do it as described by NHS Scotland in the NHS Inform website under the “How the NHS handles your personal health information” section. NHS Scotland is made up of various organisations such as NHS Health Boards, GP practices, the Scottish Ambulance Service or NHS National Services Scotland (the common name of the Common Services Agency for the Scottish Health Service). These organisations are individually responsible for your personal health information. In terms of data protection and privacy laws, they are known as ‘data controllers’. Find out more about NHS Scotland in the link provided above.
  • 5. PATIENT DECLARATION

    I declare that the information I have given on this form is correct and complete. I understand that, if it is not, appropriate action may be taken. To enable NHS National Services Scotland to confirm my eligibility to lawfully register with a GP and for the purposes of prevention, detection, and investigation of crime, the minimum necessary information from this form could be disclosed to relevant authorities. I understand that more comprehensive information about how NHS Scotland handles my data is available from NHS Inform. This information can be provided in other languages and formats on request. The NHS Inform helpline provides an interpreting service.
  • DD slash MM slash YYYY

Opening Hours

Mon: 8.20am – 5.30pm
Tues: 8.20am – 5.30pm
Wed: 8.20am – 5.30pm
Thurs: 8.20am – 5.30pm
Fri: 8.20am – 5.30pm
Sat: CLOSED
Sun: CLOSED

Please note: The practice is closed from 1.00pm – 1.45pm Every Wednesday for staff training.

Public Holidays - Closed

Monday 1st January
Tuesday 2nd January

Out of Hours

Out of hours care is provided by NHS 24

111
Please note this is for urgent and emergency problems only.

We offer early and late surgeries during the week please ask the receptionist for appointment availability

Contact

Call: 01292 264 260
Fax: 01292 292 160

Address

Fullarton Medical Practice
40 Dalblair Road
Ayr, KA7 1UL