St Philips Medical Centre

Online patient registration


> My Details

> St Philips web site

This site allows students of the London School of Ecnomics (LSE) to administer their medical information online to provide quick and efficient interaction with the medical centre.

Please fill in as much of this form as possible. Mandatory fields are indicated with a red border and must be completed.

Patient Details

Title (Mr / Mrs / Miss / Ms)
First Name
Last Name
Previous surnames
Date of Birth (dd/mm/yyyy)
NHS Number
Sex	Male Female
Town and Country of birth
Country of residence
Term Address
Post Code
Telephone Number
Course
Course start date
Course end date

Please help us trace your previous medical records by providing the following information:

Your previous address in the UK
Name of previous doctor while at that address
Address of previous doctor

If you are from abroad:

Your first UK address where registered with a GP
If previously resident in UK, date of leaving
Date you first came to live in the UK

Now some details for contacting you:

Your home (non-term) address
As confirmation of your details, please enter you email address
Please enter a password so that you can revisit your details and amend as required
Please re-enter your password

St Philips Medical Centre