Golborne Medical – West Ten GPs

16 Golborne Road, Ladbroke Grove, W10 5PE


Register as a new patient (manual form)

Download forms

You can submit a new registration request online here.

If you would rather submit your application to register in person or by email, please download and complete the forms below and deliver to the surgery in person with your proof of ID and address:

(1) New Registration (all)

(2) AND one supplementary information form:

Please print these, and hand them in at the practice. Alternatively please email them to us at [email protected].

  • We aim to action new registrations within two working days
  • Full medical records can take several weeks to arrive at the Practice
  • If you are not able to fill in our form, or provide proof of ID, please contact us by phone or come in and speak to our reception team for alternative registration methods.