Carlton Street, Burton-on-Trent, Staffordshire, DE13 0TE
King Street, Burton-on-Trent, Staffordshire DE14 3AG

Carlton Street: 01283 511 387
King Street: 01283 741 177

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Registering with Carlton Group Practice

Practice Catchment Area

Please telephone the surgery to ensure you are living within our catchment area.

Currently we take on patients from the Horninglow and Eton ward area as well as Stretton, Rolleston-On-Dove and parts of Anslow. We do not take patient from Branston, Stapenhill, Winshill or Central Burton.

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How To Register As A Patient

If you live in our practice area and wish to register as a patient at our surgery then we need certain information from you and each member of your family so as to be able to trace your previous medical records.

To register, simply call into the surgery bringing with you your NHS medical cards from your previous NHS doctor and 2 forms of proof of address and identity (see Proof of Address and Identity section below).

I do not have my Medical Card?

If you do not have your medical card, you will need to complete form GMS1, you can do this when you visit, download a copy here:

Permanent Patient Registration Form (GMS 1)

This may arise if you cannot find your cards or if you do not have any e.g. if you have recently arrived in the country. This is less preferable since it may take longer to trace your medical records and you will have to fill in more paper work, so please find your medical cards if you can.

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Medical Questionnaire

When you register you will also be asked to fill out a medical questionnaire. This is because it can take a considerable time for us to receive your medical records. Download and print off the questionnaire, fill it out and bring it with you to the surgery:

Download Medical Questionnaire Adult (Over 14 years of age)

Download Medical Questionnaire Child (Under 14 years of age)

Alcohol Screening Tool

Alternatively you may wish to collect this from the surgery.

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Communication Consent Form

Patient privacy is important to us, and Carlton Group Practice would like to communicate with you regarding any activities that may be of interest which means that we need your consent.

This may include using emails to provide updates on new developments at the practice, and the use of text messaging to send patients reminders about details of their next appointment.

Emails and text messages are generated using a secure facility, but because they are transmitted over a public network they may not be secure. Email and text communication will never be used for urgent communications. Your contact details will be used solely in relation to healthcare services offered by the practice and you can choose to opt out of the services at any time by contacting reception.

Download our Patient Consent for Text Message or Email Communication. When complete please hand this into reception.

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Proof of Address and Identity

We will require 2 forms of ID (proof of address proof of identity) for all patients wishing to register with the surgery, acceptable documentation include;

Personal Identity

  • Current Valid EU passport
  • Current Valid non EU passport
  • Current Valid National ID card (non UK Nationals)
  • Current Full UK Driving Licence
  • Current UK / EU Photocard Drivng Licence
  • Current State Pension notification letter
  • Current Benefits Agency letter
  • Current Blue disabled Drivers Pass
  • Current HMRC Tax Code Notification
  • Birth Certificate

Address Verification

  • Mortgage Statement
  • Rental Agreement
  • Recent Utility Bill - Gas, Electric, Water, Telephone (Not Mobile)
  • Current Council Tax Bill
  • Current Council Rent Book
  • Bank / Building Society Statement (current within 2 months)
  • Solicitors letter confirming completion of house purchase
  • HMRC Tax Notification documentation

We ask that all patients requesting to register with the practice are present when registering.

In order for us to process your request please attend the surgery between 11.00am and 2.30pm. if you are registering at Carlton Street surgery and 11.30am and 12.30pm, Tuesday, Wednesday and Thursday, if you are registering at King Street surgery.