Thatcham Medical Practice
Vision Online Appointment – Registration Form
Mobile Phone Number:
Date of Birth:
Proof of Identification:
Please provide one (1) original document as evidence of your identity. It
will be photocopied and immediately returned to you. Example: Passport,
Council Tax statement, Driving licence NI number card.
Method of receiving Registration Letter:
The information you supply us will be used lawfully, in accordance with the Data Protection Act
1998. The Data Protection Act 1998 gives you the right to know what information is held about
you, and sets out rules to make sure that this information is handled properly.
Action by: Date: