Out of Area Consent Form

Our current catchment area is Rushall, Shelfield and Pelsall. You can now request to remain at our surgery if you are moving outside of this area.

However registering with a surgery that is not local to you can affect any community health services you receive e.g Midwifes or District Nurses. We are also not able to offer home visits to patients outside our catchment area.

If you are moving and wish to remain at our surgery you can request to remain a patient here by completing the form below.