New Patients

How to register as a New Patient

If you wish to Register with St Agnes Surgery and live within our catchment area including St Agnes, Mount Hawke, Blackwater, Perranporth and some surrounding areas:-

  1. Please click on the link below (New Patient Registration Form) to open the form. When you have completed all of the details, click on the "Submit" button to mail your form to us.  When you visit the surgery for the first time you will be asked to show us some identification such as a driving licence or passport.
  2. Please then email to the relevant New Patient Health Questionnaire (Adult/Child/Newborn).
  3. If required, please complete the Access to Online Service Agreement and e-mail this to us with 2 forms of identification (1 photo ID and 1 with your address on). Please note, we are unable to grant access until these have been received.
  4. For Proxy Access to the Online Service please complete this form and return it to us with 2 forms of identification for each representative and 2 for the patient you would like access for. Please note, we are not able to grant access until these have been received.  If the representative is a patient of St Agnes Surgery please ensure you have registered for the Online Service also.

Our Practice area is shown on the map opposite.

Practice Boundary

Your address is within the catchment area.
Your address is outside of the catchment area.
Address not found.

New Patient Health Questionnaires & Online Service applications


Should you wish to make appointments or order repeat medication online, please complete the Access to Online Services Agreement form and provide identification as mentioned above.

New Patient Health Questionnaire - Adults

New Patient Health Questionnaire - Child

New Patient Health Questionnaire - Newborn (up to 2 months)

Access to Online Service Agreement - Over 16 years

Proxy Access to Online Service Agreement - Under 16 years

Accessing Online Services Leaflet

You may also download our Large Print Practice Leaflet here.

Temporary Patient Registrations

If you are ill while away from home under COVID guidance you are advised to contact your own practice in the first instance as all practices are able to send prescriptions to the area you are staying and telephone/video consultations.  You may also be directed to NHS 111 who will then refer you through to our practice.

To register as a temporary patient simply contact the local practice you wish to use. Practices do not have to accept you as a temporary patient although they do have an obligation to offer emergency treatment. You cannot register as a temporary patient at a practice in the town or area where you are already registered.

Non-English Speakers

These fact sheets have been written to explain the role of UK health services, the National Health Service (NHS), to newly-arrived individuals seeking asylum. They cover issues such as the role of GPs, their function as gatekeepers to the health services, how to register and how to access emergency services.

Special care has been taken to ensure that information is given in clear language, and the content and style has been tested with user groups.

Open the leaflets in one of the following languages:

england flag English Iran flag Farsi Urdu flag Urdu
albania flag Albanian Bengali flag Bengali india flag Hindi
egypt flag Arabic Croatian flag Croatian lithuania flag Lithuanian
bulgaria flag Bulgarian Punjabi flag Punjabi poland flag Polish
china flag Chinese (Cantonese) Somali flag Somali portugal flag Portuguese
china flag Chinese (Mandarin) Gujerati flag Gujerati spain flag Spanish
russia flag Russian Turkish flag Turkish French flag French

Disabled Patient Facilities

All clinical areas and toilets are easily accessible for the disabled

There is ample car parking available with spaces for disabled patients to park (but only for parking whilst using the surgery please!).

Change of Personal Details

Please let us know as soon as possible of any changes to your personal details (i.e. name, address, contact numbers) to enable us to keep our records up to date.

You may use the online form here to notify us of any changes. Alternatively please pick up a paper form at the practice. You need to make sure all members of the family are included on the form.