Tell us whether you accept cookies

We've put some small files called cookies on your device to make our site work. We would also like to use analytical cookies to understand how our site is used and improve user experience. Analytical cookies send information to Google Analytics.

Let us know your preference. We will use a cookie to save your choice. Before you make your choice you can read more about our cookie policy.

Mickleover Medical Centre NHS GP Surgery in Derby

Register for online services

Section

Address, including postcode: *

I wish to have access to the following online services (please tick all that apply):

Booking Medical Appointments

Requesting Repeat Prescriptions

Accessing my Summary Care Record (SCR) (Standard Access)

Accessing my Detailed Coded Record (DCR) (enhanced access)

I wish to access my medical record online and understand and agree with each statement: *

1. I have read and understood the information leaflet provided by the practice

2. I will be responsible for the security of the information that I see or download

3. If I choose to share my information with anyone else, this is at my own risk

4. I will contact the practice as soon as possible if I suspect that my account has been accessed by someone without my agreement

5. If I see information in my record that is not about me or is inaccurate, I will contact the practice as soon as possible

Signature *

Date

Preferred Contact Method (please select at least one):

Phone

SMS

Letter

I consent to receiving SMS messages from the practice

Yes

Terms and Conditions

I understand that it is my responsibility to keep my account secure by keeping my details confidential
I understand that I can terminate my account at any time by contacting the surgery, or change my log in details by re-registering and that this form will be kept on my electronic records
I understand that my registration will be revoked if I constantly miss or cancel appointments.

Terms and conditions *

I accept the terms and conditions stated above

If you are human, leave this field blank.

Vicarage Road
Mickleover
Derby
DE3 0HA

Get directions

01332 513283

Feedback and complaints

Wellbeing

Accessibility statement

Website policies