Baby - First Ever Registration - Almond Group Practice

Admin message to Practice

NEEDS TO PROVIDE Birth Notification Card from Hospital or the NHS Registration Form (EC58) from National Records.

Baby’s Details

Forenames

Surname

Date of Birth

Sex

Male

Female

Address

Town

Postcode

EH29, EH52 and some within EH30 and EH28 as per the boundary

Which town are you nearest to? (for assigning you a health visitor))

Kirkliston, Newbridge or Ratho

Winchburgh

Parent / Carer Details

Who looks after the baby?

Mother

Guardian

Mother’s name

Mother’s Date of Birth

Guardian’s name

Guardian’s Date of Birth

Mobile of Mother or Guardian

If you don’t have a mobile number, please state ‘none’. However, we cannot register you without a mobile or landline number

Landline of Mother or Guardian

Is the Baby’s Father registered at this Practice?

Yes

No

Father’s name

Father’s Date of Birth

Mobile of Father

NHS Registration Form (EC58)

We are required to check your Baby’s Birth Notification Card or NHS registration form

I will upload this here

I will bring this into the practice another time (we cannot complete your registration until this has been done)

Baby registration form

Maximum file size: 5MB

HOW THE NHS USES YOUR INFORMATION

The information you have provided will be used by NHS Scotland to carry out its various functions and services including scheduling appointments,
ordering tests, hospital referrals and sending correspondence. Read more using the link below.

“How the NHS handles your personal health information”

Parent / Carer Declaration

I declare that the information I have given on this form is correct and complete. I understand that, if it is not, appropriate action may be taken. To enable
NHS National Services Scotland to confirm my eligibility to lawfully register with a GP and for the purposes of prevention, detection, and investigation of crime, the minimum necessary information from this form could be disclosed to relevant authorities.

I understand that more comprehensive information about how NHS Scotland handles my data is available from NHS Inform.

Are you the parent or a carer?

Parent

Guardian

What is your name?

Your relationship to the Baby

Your mobile number in case we need to contact you

Signature

Clear

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our privacy policy to discover how we protect and manage your submitted data.

Consent

I agree to the privacy policy

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