Online Registration With The Practice

We can only accept new patients who live in our practice area.

If you wish to register click on the link below to open the form. This does not register you at the Practice, but is only your intention to do so.

NOTE: You will not be able to book appointments until you have been fully registered. The Registration process normally takes 48 hours from receipt of all of the completed forms and surgery checks. 

 NHS Register with Old Harlow Health Centre 

Note that by sending the form you will be transmitting information about your self across the Internet and although every effort is made to keep this information secure, no guarantee can be offered in this respect.

Note: We will keep the the submitted online forms received for one month from date of submission, if you do not come in to sign the form and provided all other necessary information we will destroy any submitted information..

We only accept patients who live in our catchment area. See Registration tab.