How Do I Change My Personal Details?

HOW DO I...
CHANGE MY DETAILS?

Please let us know promptly if you change your name or address. If you move out of the practice area we request that you change to a practice closer to your new address. This is necessary because the doctors have agreed a practice boundary with BPRPCT (see map on the back cover). This boundary defines the area the doctors cover so that visits and emergencies can be dealt with swiftly and safely.

CHANGE MY DETAILS ONLINE

You can also use the form below to email the surgery of any changes to your details.

CHANGE OF PATIENT DETAILS

Title:

First Names:

Last Name:

Date of Birth
(dd/mm/yyyy):

Your Usual Doctor:

Email Address:

Change of Name

New Title:

New Surname :

New Forename :

Change of Address/Telephone Number

Old Address 1:

Old Address 2:

New Address 1:

New Address 2:

New Postcode:

New Home Phone No :

(Including STD code)

New Mobile Phone No :

New Work Phone No :

CONFIDENTIALITY - TERMS AND CONDITIONS:
The internet is not secure, and the transmission of data to request medication is entirely at the patient's own risk. The practice accepts no responsibility for breaches in confidentiality resulting from patients' transmissions.

I accept the terms and conditions above