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OVER 16 REGISTRATION STATUS FORM Tel: 01332 340381 www.macklinstreetsurgery.co.ukThank you for applying to join Jacklin Street Surgery. We would like to gather some information about you and ask that
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How to fill out new patient under 18

01
Step 1: Gather all necessary documents such as the patient's identification card, insurance information, and parent/guardian contact information.
02
Step 2: Fill out the patient's personal information section, including their full name, date of birth, address, and contact details.
03
Step 3: Provide the patient's medical history, including any previous illnesses, allergies, medications, and ongoing treatments.
04
Step 4: Complete the insurance information section, including the policy number, group number, and primary insurance holder's name.
05
Step 5: If the patient is a minor, ensure that the parent or legal guardian signs the consent form.
06
Step 6: Review the completed form for any errors or missing information before submitting it.
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Step 7: Submit the filled-out form to the designated personnel or clinic staff for processing.

Who needs new patient under 18?

01
Children and adolescents under the age of 18 who are new patients to a healthcare facility or clinic.
02
Parents or legal guardians of minors seeking medical care or treatment.
03
Medical professionals who require comprehensive patient information for individuals under 18 years old.

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A new patient under 18 refers to a minor who is seeking medical care for the first time at a specific healthcare facility or by a particular provider.
Parents or legal guardians of the minor are required to file a new patient form for individuals under 18.
To fill out a new patient form for individuals under 18, provide the minor's personal information, medical history, insurance details, and consent from a parent or guardian.
The purpose of filing a new patient form for those under 18 is to gather necessary information for proper medical treatment and to ensure compliance with legal requirements regarding minors.
The information that must be reported includes the minor's personal details (name, age, gender), medical history, current medications, allergies, insurance information, and consent from the parent or guardian.
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