Change of Contact Details Form

We are no longer able to accept name changes via the internet.

Please come to the surgery, with photographic ID (also marriage certificate if name changed due to marriage). We will then ask you to complete a form and take copies of ID.

Please upload proof of address change like an official letter, utility bill or estate agent letter.

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.