Registration

If you would like to register with us, please print off and complete the following forms, and then post or fax them to us:

Private Patient Registration Form (PDF)

New Patient Questionnaire (PDF)

Bankers Order Form (PDF)

The forms linked above are in PDF format. Almost all computers will be able to open them, but if you find that yours can't you can download and install the free Adobe Reader.

Membership policy

Minimum membership period is one year. If you decide to leave the scheme, you will need to write to the Courtfield Private Practice giving one month's notice of your intention. Membership cancellation within one year of joining will incur an administration fee of:

• Less than 3 months membership - 2 months' fee
• Less than 6 months of membership - 1 month's fee