Registration Form | Ramsay Healthcare
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Form Information

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Registration Form

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Communication Form

Registration Form

Thank you for visiting Ramsay Health Care UK registration. Can you please take the time to carefully complete your details on the following registration form. It should take a maximum of 5 minutes to complete.

  • 1) The Hospital you will be treated at
  • 2) The name of your Consultant
  • 3) Your GP information
  • 4) Your NHS number will also be helpful but not essential
  • 5) Patient Number (found on your correspondence from us)

Please ensure you have this information readily available as you will need to complete the form in one session and will not be able to save and return later to complete the form.

  • 1) The Hospital you will be treated at
  • 2) The name of your Consultant
  • 3) Your GP information
  • 4) Your insurance company details
  • 5) Your insurance policy number
  • 6) Your authorisation number
  • 7) Your NHS number will also be helpful but not essential
  • 8) Patient Number (found on your correspondence from us)

Please ensure you have this information readily available as you will need to complete the form in one session and will not be able to save and return later to complete the form.

  1. 1) The Hospital you will be treated at
  2. 2) The name of your Consultant
  3. 3) Your GP information
  4. 4) Your NHS number
  5. 5) Patient Number (found on your correspondence from us)

Please ensure you have this information readily available as you will need to complete the form in one session and will not be able to save and return later to complete the form.

Registration Form

Admission Information

Medical Insurance Information

ALL PATIENTS: I hereby undertake to pay Ramsay Health Care UK Operations limited (Ramsay Health Care UK) for services and materials relating to my treatment as a private patient including in the circumstances where medical insurance proves not to cover the specific course or part of the course of the treatment. This also applies to diagnostic treatments, therefore it is important that you seek clarification from your insurer as to what will be covered in your policy as you will be responsible for any settling. Please be aware that pre-operative tests will be invoiced to your insurance company (where applicable) as Outpatient charges.*

Welcome to Ramsay Health Care UK

Ramsay Health Care UK Operations Limited is committed to ensuring the privacy and confidentiality of your personal information, and to protect it from unauthorised access and disclosure.

In order to provide you with accurate and timely information about your appointments and treatment with us, we will need to contact you, and ensuring we use the best method of communication is vital.

Please let us know how you would prefer us to communicate with you

To improve our level of care and service; Ramsay is required to monitor patient satisfaction of the services provided to you. We may contact you by email through our third party survey provider, Cemplicity, to ask you to complete a patient satisfaction survey. Please note that we will share your name and email address with Cemplicity to enable them to contact you directly.

To keep you informed about our services; are you happy for Ramsay Health Care to:

We will only send you marketing information where you have agreed to opt in to receive it. We will only use your preferred communication channels to contact you and you will be given the option to select this when opting in. You can stop us from contacting you for marketing purposes by clicking on the ‘unsubscribe’ link embedded within the email that has been sent to you. Doing so will remove your personal data from our contacts list automatically.

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By clicking submit, I agree that the signature will be the electronic representation of my signature for all submissions of my registration form - just the same as a pen-and-paper signature. For more information visit our privacy policy.

Thank you for providing your information

We will get back in touch if there is anything we need to clarify.

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