Step 1 of 2 – Initial Setup Form

Please complete the form below, followed by the SurgeryWeb agreement.

Once we receive your submission, we’ll get started on setting up your new website and will be in touch within a couple of days with your access details.

"*" indicates required fields

Which SurgeryWeb template would you like to sign up for?*

Not sure? Take a look at the options here

Your Name*

Your Role*

Your Email*

Practice/PCN Name*

Organisation (ODS) Code*

Name of your ICB

Organisation Address*

Street Address Address Line 2 City ZIP / Postal Code

Organisation Telephone Number*

Do you have an existing website?*

Yes

Web Address (URL)*

Who is your current supplier?*

This is required to request that your domain name be transferred to us.

What email address would you like the online forms to send submissions to?

How did you hear about SurgeryWeb?*

Google

PracticeIndex

Purchase Direct

Recommendation from another Practice

Other

What is your registered username?*

Promo Code*

Please enter their NACS/ODS Code here*

If you have been referred, you and your referring Practice will both receive 5% discount off your first (or next in their case) invoice.

By using this form you agree with the storage and handling of your data by this website. *

Try Our Demos

See SurgeryWeb in action! Explore our fully interactive demos to experience how our websites can transform your GP surgery's online presence. Each demo showcases the features, functionality, and customisation options available, so you can find the perfect fit for your practice.

Click one of the tiles to the right

NHS-framework Template

Seamlessly connect your patients to essential online services, fully compliant with NHS England recommendations.

Classic Template

A flexible, customisable and responsive website solution — built to meet best practices but without enforced NHS content guidelines.

Step 1 of 2 – Initial Setup Form

Try Our Demos

NHS-framework Template

Classic Template

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