Summertown Group Practice

Summertown Health Centre, 160 Banbury Road, Oxford OX2 7BS
Telephone: 01865 515552 | Fax: 01865 311237

St Antony’s Registration

Registration Form

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Please help us to trace your previous medical records by providing the following information:
If you are from abroad please provide the following information:
If you are returning from the armed forces please provide the following information:
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Please click here to view the information:

Summary Care Record and Oxfordshire Care Summary – Your Choice

We recommend opting into Oxfordshire care summary records

Your choice for Summary Care Record
It is important to complete this information as your new practice cannot make a decision for you. Without your direction, we cannot guarantee that your wishes will be met, even if you have previously made a similar choice in another practice.

If the person signing below is not the patient, please also enter the signatory’s name and relationship to the patient, e.g. PARENT, GUARDIAN, ATTORNEY

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St Antony's College, 62 Woodstock Road, Oxford, OX2 6JF

Contact Details
We would like to be able to contact you by email and text on matters regarding your health or to text you reminders about your appointments. If you are happy for us to contact you in this manner please provide your email and mobile telephone number:
If you need to be seen by a doctor at home during vacation, please register as a TEMPORARY RESIDENT. If you register as a normal patient you will be removed from our patient list and will need to re-register with our practice on your return to college.
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Medical History
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Immunisation History

Please indicate which of the following diseases you have been vaccinated against. Where you tick 'yes' you will be asked for the date(s) you received the vaccination. If you have been vaccinated against a disease please indicate 'yes' even if you do not know the date(s) you received the vaccination.
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Ethnicity & Language Questionnaire

Thank you for completing this registration form. When your form is complete please press the submit button. Your registration form will be sent to the Practice. We will register shortly before you are due to start at your college.
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If you wish to, you can now use the internet to book appointments with your GP and request repeat prescriptions for any medications you take regularly.

If you wish to use this service, please complete the details below and we will email your log in details to you.

You can also view your medical record online. This can help you manage your medical conditions. It also means you can access it from anywhere in the world should you require medical treatment on holiday.

If you wish to sign up for medical record viewing, you will need to present at the practice to complete the appropriate form and to present proof of identification in the form of a passport or photo card driving license.

It will be your responsibility to keep your login details and password safe and secure. If you know or suspect that your record has been accessed by someone that you have not agreed should see it, then you should change your password immediately.