New Patient Registration

To register at Billericay Medical Practice please complete the following forms.

Please note that you need to send a copy of your photo ID and 2 proof of address, dated within the last 3 months (this can be a utility bill or letter). For under 16's who do not have a photo ID, please include a copy of their birth certificate. 

New Patient Registration Pack - Adult

New Patient Registration Pack - Under 16 year olds

Newborn Babies Registration Form

Please email the completed forms with a photo of your photo ID and proof of address to or put the forms and copies of your documents in the white post box on the front of the building. 

Please allow 2 full working days for your application to be processed. 

We can only register patients who are living in the Billericay area, if you are unsure if you are within our catchment area, please check with reception on 01277 658071. 

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