SystmOnline Sign Up Form

First Name*
Last Name*
NHS Number
Date of birth*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City County / State / Region Post Code Country
Email*
Enter Email Confirm Email
Please provide an email address to link to your patient record
Phone
Please upload a copy of your photo ID. (Driving License/Passport/Bus Pass etc*
Accepted file types: jpg, gif, tif, png, Max. file size: 10 MB.
We require this to verify your identity before granting access to Online Services

Please allow 5 working days for your registration to be processed

Please note that we are unable to register you for online access without suitable identification

Some useful help for using the online service can be found here

If you have any questions regarding online access please email the surgery at enquiries.kingsteigntonmedicalpractice@nhs.net