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Request to join Fairbrook Medical Centre

Are you already registered at a practice in the local area and wish to change surgery?

If you are registered with a surgery in the local area already and wish to change surgery, please complete the link below and return the form to us

Our Practice Manager Michele Cain will then contact you at her earliest convenience, prior to completing our registration forms. 

Request to Join Fairbrook Medical Centre from another Practice in the area
Please use format day/month/year e.g. 12/05/1979

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.