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Registration

Registering at Cleveland Clinic as your Primary Practice in Jersey

To register with Cleveland Clinic, you will need to complete a registration form. We need to have this handed to us in one of our surgeries along with your :

  • proof of identification (passport, driving licence)
  • proof of address (utility bill)
  • JY social security card.

We will then review your application and contact you to confirm we are registering you as a patient. A double appointment with a doctor will be booked, this will enable them time to update your medical information in regards to history and any medication you may be taking. This is a legal medical requirement.

Visitors

Please download and complete a Visitors Registration form. Please be aware that payment in full is expected during the visit.

Amending your information at Cleveland Clinic.

Should you need to make any changes to your personal information the amendment form must be completed and handed into one of our surgeries. You will be asked to show Identification to confirm it is you and for changes of address, proof of address will be required.

Access to your data held at Cleveland Clinic.

Should you need to have access to your records please complete the subject access form and hand into one of our surgeries along with proof of identification to confirm it is you.

Register

Download & Complete

Please download and complete the appropriate form from below. You'll need to print out, sign and return it to us at your earliest convenience. You can also pick up a form from any of our surgeries. Please be aware the form must be signed by you, as we need to inform the General Hospital of your new details.