Change Personal Details

Please let us know as soon as possible if you change your address, telephone number or name. It is important that we have up to date contact details in case we need to contact you.

We send relevant information, such as appointment reminders and test results, to you via text and email, please speak to reception if you wish to opt out of this service.

Please note: If your name has changed due to Marriage or by Deed Poll, can you please provide us with a copy of the appropriate document (requirement of Department of Health). Alternatively if you have moved house, please make sure you still live within our Practice Boundary.

Please Note – once you have submitted this information, any reply or acknowledgement from us will be sent to the email address you provide at top of the form. This response may include personal and sensitive information about you. We therefore strongly advise that you provide a personal email address that only you have access to. If you do not wish for us to communicate with you via email, please do not use this form and call us instead.

Change of name or address

Change of name or address

About you

Please use this date format: DD/MM/YYYY.
This email address will be used for all correspondence relating to this request. Please be aware that if anyone else has access to this email address that they may see responses sent to you.
Please select the information you are wanting to update?

Change of Name

If your name has changed due to Marriage or by Deed Poll, can you please provide us with a copy of the appropriate document (requirement of Department of Health).
How do you wish to be known? *

Change of Address

Please check that your new address is still within our practice boundary. If you have moved outside of this, you will need to re-register at another surgery.
(only if they are registered at the practice)

Update Contact Numbers

Would you have any objection to being reminded by text for appointments?