County Road Surgery

109 County Road Ormskirk Lancs L39 1NL

New Patient Registration

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Patient's Details



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


If you are from abroad


If you are Returning from the Armed Forces


If you are registering a child under 5



NHS Organ Donor Registration

I want to register my details on the NHS Organ Donor Register as someone whose organs/tissues may be used for transplantation after my death.

For more information, please ask at reception for an information leaflet or visit the website www.uktransport.org.uk, or call 0300 123 23 23.


NHS Blood Donor Registration

I would like to join the NHS Blood Donor Register as someone who may be contacted and would be prepared to donate blood.

For more information, please ask for the leaflet on joining the NHS Blood Donor Register
My Preferred address for donation is: (only if different from above, e.g. your place of work)