CEP Forms Registering & De-registering from CEP RegistrationPlease enable JavaScript in your browser to complete this form.I am/the serving person in this family is *ArmyRAFNavyUKBCService/Staff Number *Rank/Title *First Name *Last Name *Date of Birth *Sex at birth *Gender *Contact telephone number *Please use a telephone number you will be using while in location.Civilian email address *Further work email addresses can be added at a later date but for registration purposes please ensure this is a civilian email addressCountry of Assignment *Town of Assignment *Expected/Actual Date in Country *Are you a Carer? *YesNoAre you a Care Leaver? *YesNoAre you pregnant or under the care of a midwife? *YesNoN/ADo you hold a firearms licence? *YesNoPrevious UK Postal Address *Required for Civil Servants and spouses/family members to allow us to request and track UK GP records. For serving personnel, please type N/AI have additional family members to add (1) *YesNoI amSpouse/PartnerChild who will be accompanying to postChil who will be in Boarding School/UniversityFirst NameLast NameDate of BirthSex at birthGenderContact Telephone NumberCivilian email addressFurther work email addresses can be added at a later date but for registration purposes please ensure this is a civilian email addressExpected/Actual arrival date in countryAre you a carer?YesNoAre you a care Leaver?YesNoAre you pregnant or under the care of a midwife?YesNoN/APrevious UK Postal AddressRequired for Civil Servants and spouses/family members to allow us to request and track UK GP records.I have additional family members to add (2) *YesNoI amSpouse/PartnerChild who will be accompanying to postChil who will be in Boarding School/UniversityFirst NameLast NameDate of BirthSex at birthGenderContact Telephone NumberCivilian email addressFurther work email addresses can be added at a later date but for registration purposes please ensure this is a civilian email addressExpected/Actual arrival date in countryAre you a carer?YesNoAre you a care Leaver?YesNoAre you pregnant or under the care of a midwife?YesNoN/APrevious UK Postal AddressRequired for Civil Servants and spouses/family members to allow us to request and track UK GP records.I have additional family members to add (3) *YesNoI amSpouse/PartnerChild who will be accompanying to postChil who will be in Boarding School/UniversityFirst NameLast NameDate of BirthSex at birthGenderContact Telephone NumberCivilian email addressFurther work email addresses can be added at a later date but for registration purposes please ensure this is a civilian email addressExpected/Actual arrival date in countryAre you a carer?YesNoAre you a care Leaver?YesNoAre you pregnant or under the care of a midwife?YesNoN/APrevious UK Postal AddressRequired for Civil Servants and spouses/family members to allow us to request and track UK GP records.I have additional family members to add (4) *YesNoI amSpouse/PartnerChild who will be accompanying to postChil who will be in Boarding School/UniversityFirst NameLast NameDate of BirthSex at birthGenderContact Telephone NumberCivilian email addressFurther work email addresses can be added at a later date but for registration purposes please ensure this is a civilian email addressExpected/Actual arrival date in countryAre you a carer?YesNoAre you a care Leaver?YesNoAre you pregnant or under the care of a midwife?YesNoN/APrevious UK Postal AddressRequired for Civil Servants and spouses/family members to allow us to request and track UK GP records.I have additional family members to add (5) *YesNoI amSpouse/PartnerChild who will be accompanying to postChil who will be in Boarding School/UniversityFirst NameLast NameDate of BirthSex at birthGenderContact Telephone NumberCivilian email addressFurther work email addresses can be added at a later date but for registration purposes please ensure this is a civilian email addressExpected/Actual arrival date in countryAre you a carer?YesNoAre you a care Leaver?YesNoAre you pregnant or under the care of a midwife?YesNoN/APrevious UK Postal AddressRequired for Civil Servants and spouses/family members to allow us to request and track UK GP records.I am aware that the CEP may contact myself or my family members for further information if required.YesI herby confirm the requirement for myself and my family members to enrol with the MOD Healthcare Partner One HMG (Healix) and understand that we should seek clinical care initially through the local host nation system. For further information please refer to the CEP Practice Information Leaflets.YesGDPR ConsentI consent to having the Central European Practice store my submitted information to enable them to perform medical support functions required by Defence.Submit De-RegistrationPlease enable JavaScript in your browser to complete this form.Service/Staff Number of Serving Person De-Registering *First Name *Last Name *Date of Birth *Expected leaving date *Expected new unit (Service Personnel Only) *I have family members to de-register (1) *YesNoName *FirstLastDate of Birth *I have family members to de-register (2) *YesNoName *FirstLastDate of Birth: *I have family members to de-register (3) *YesNoName *FirstLastDate of Birth *I have family members to de-register (4) *YesNoName *FirstLastDate of Birth *I have family members to de-register (5) *YesNoName *FirstLastDate of Birth *Expected New GP Facility (Civilians Only) - If unknown please indicate this in the box *GP Postal Address - If unknown please indicate this in the box *I herby confirm the de-registration of myself and my family members. I am aware that the CEP may contact myself or my family members for further information if required. *YesGDPR Consent *I consent to having the Central European Practice store my submitted information to enable them to perform medical support functions required by Defence.Submit
