Online Services Request Form

Please enter all your details below.  You will need to visit the practice and give a receptionist some photographic identification – current passport or driving licence. If you do not possess either of these, we will accept your NHS card.

Your pin number and access ID number, along with instructions for access to internet booking will be ready for collection from the surgery within the next 7-10 working days.

Note: For confidentiality purposes we only accept request forms for patients aged 16 years and over.

We are unable to issue access unless one of the above forms of identity is produced.

If you do not have a passport or driving licence, and cannot find your NHS card, you may apply for a copy from Birmingham Shared Services Agency on 01922 603150.

Online Services Request Form
If you do not have a passport or driving licence, and cannot find your NHS card, you may apply for a copy from: Birmingham Shared Services Agency on 01922 603150
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