Pre-Registration with the practice

If you wish to pre-register click on the link below to open the form. When you have completed all of the details, either e-mail/post or drop the form into us.

When you visit the surgery for the first time you will be asked to sign the form to confirm that the details are correct
Note that by sending the form you will be transmitting information about your self across the Internet and although every effort is made to keep this information secure, no guarantee can be offered in this respect.

Please use the search function on the map below to ensure you live within the practice area before completing the registration form.

Please note that this is an approximate boundary only.  If you live close to the boundary you may fall outside the practice area. Please check with a member if staff.

If you wish to apply to be registered with the Practice, please complete and print off the registration form below

Grosvenor Road Surgery consent form

We also require photographic ID, proof of address and a medication list if applicable. A second form is needed to complete the application

• We need a HS200 form for patients registering from another surgery in NI or from the UK
• We need a HSC/R1 form for patients registering outside of the UK or if you haven't had a GP in the last 12 months

You can get these forms from reception

Completed forms and supporting documents can be emailed to reception.z00075@gp.hscni.net

or post/drop in to

Grosvenor Road Surgery

216 Grosvenor Road

BELFASTBT12 5LT