New patient registrations – additional questions Please complete these additional questions Personal DetailsFirst name Surname Date of Birth Day Month Year Gender Female Male Supplementary QuestionsHow do you prefer to be addressed e.g. ‘Bob’ instead of ‘Robert’? Leave empty if no preference Optional Which site (surgery) would you like to attend The Valley Surgery Chilwell Meadows Surgery Please note that you will always be seen at this siteHow do you keep fit? Optional