Clarkston Medical Digital Register

Use the form below to give us your details for registering for online services, including formal opt in/out for SMS notifications, email address provision and to be provided with an activation code for Patient Access, the system that allows you to book appointments and order prescriptions securely online instead of over the telephone.

We’ll then email or text you within two working days with an activation code for the Patient Access website.

NB – works better in landscape orientation on mobile

EMIS Access Register

Use this form to let us know your preferences for SMS/text communications, email and online access. If you have registered with the Practice and given us a mobile phone number, we would like to use this to send you text messages relating to your health. This may include reminders of appointments, and health campaigns e.g. Flu, Shingles etc. Your details will only be used by the practice and never shared. You also have the option of providing us with an email address, which can be useful in the event that we need to share documents with you. Please note - the security of your own email provider is beyond our control. Finally, we would encourage you to register for Patient Access, which allows you via an app or browser to book appointments and order prescriptions, without having to wait in a phone queue. Please note - we will need you to have opted in to mobile communications or provided an email address in order to send you a registration code for Patient Access.

I consent to the use of my mobile number for communications:(Required)

Yes

No

Only for phone calls, not for SMS services

Mobile number

I consent to the use of my email for communications:(Required)

Yes

No

Email address (if applicable)

I would like to register for Patient Access and would like to receive my authorisation code via:

Mobile

Email

Name(Required)

Date of Birth(Required)
DD slash MM slash YYYY