Out of Area Disclaimer Form

Introduction

Welcome to our GP Practice! This form serves as a crucial disclaimer for all new patient registrations. It outlines important policies regarding the services we provide.

This disclaimer acknowledges your understanding and acceptance of this policy.

Subject: Information Regarding Out of Area Registration

Dear Patient,

Thank you for your request to register or remain register as an ‘Out of Area’ patient. As you reside outside of our practice boundary, it is important for you to understand the implications of this registration status.

Please carefully review the information below before making your decision to Register or Remain registered with our practice. 

• As an Out of Area patient, we are not obligated to provide home visits, and there may be limitations regarding your access to local community services, such as adult and social care.
• In the event of an urgent medical condition or injury that prevents you from attending our practice in person, we will advise you to contact NHS 111. This service will connect you with a local healthcare provider, which may include a face-to-face appointment or, if necessary, a home visit.
• If it is determined that you are experiencing complex health issues that necessitate the involvement of local community services, we may recommend that you register with your nearest GP practice.

If you accept these terms, you will be entitled to the full range of services offered by our practice, except for home visits. Please sign the acknowledgement page attached and return it to the practice.

Yours sincerely,

Forest Edge Practice

Please note: If you have children, you will need to complete this form for each individual