Register for Online Services

To register for our online services you will need to complete this form and then visit the practice, bringing  with you two forms of identification. One of these items should include your photograph.

We will then issue you a username and password via the email address that is provided.

Once you are registered you will be able to use the service to:

  • Order your repeat prescriptions
  • Make or cancel an appointment
  • Review your Summary Care Record

Please Note: All patients 16+ years will need to register in their own right and visit Pembroke Surgery with two forms of ID to register for online services. For children under the age of 16yrs please see the attached policy for guidance or speak to the reception team.

Register for Online Services

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.
Please select all that apply

Terms and Conditions

I understand that it is my responsibility to keep my account secure by keeping my details confidential I understand that I can terminate my account at any time by contacting the surgery, or change my log in details by re-registering and that this form will be kept on my electronic records I understand that my registration will be revoked if I constantly miss or cancel appointments.