Forms and Leaflets

The following forms and leaflets are available to download and print off on your computer.  Just click on the form required:

Let us know you are a carer – Carers Registration Form 

Let us know you have moved – Change Of Address

Choice Form For Summary Care Record

Choice Of GP Practice and Out Of Area Registered Patients 
(Must be accompanied by a completed Registration Pack for each patient requesting Out of Area Registration)

Complaints Leaflet

Patient Complaint Form

Third Party Patient Complaint Form

Ear wax self guidelines for patients
Guidance for Patients

Fees 2020 (Including Travel Vaccination Charges)

Gift Aid Declaration
For Minchinhampton Surgery Trust

Minch Registration Pack U16s – New

Minch Registration Pack Adult

Patient Consent To Share Information With Carer Form 

Patient Online Information Leaflet
For online appointment booking and repeat prescription requests. Please note pin numbers MUST be collected in person with photo ID

Patient Online Access form

Proxy Access to Patient Online Access form

PPG Leaflet

Practice Charter

Patient Information Leaflet 2020

Statement of Equal Opportunity for Patients at Minchinhampton Surgery

Transport leaflet for patients
Information about the Patient Participation Group’s Transport scheme

Travel Questionnaire
Please complete and return to the Surgery preferably 6 weeks before travel

Oral Glucose tolerance Test

Zero Tolerance Policy

Sexual Health leaflet 2020

Welcome to Minchinhampton Surgery!

Please wear a face covering when attending the surgery if you have respiratory symptoms. Please wash or sanitize your hands upon entering the building.