Change of Personal Details

If you change your name we will need you to come into the surgery with documentary evidence of the change and complete a form.

For changes of address or contact details (such as your telephone number), you can advise us using the form below or write to us. If you are receiving treatment at a hospital it might also be a good idea to inform them of any changes so that our records are consistent when we communicate with them. If you have moved between Herts and Essex it is essential to also include you Place of Birth for each member of your household as this information is required by the Health Authority and we cannot process the change without it. This should be your town of birth, if you were born in London or Glasgow please include the borough/locality. 

Change Your Contact Details (address)
Title
Would you like to receive text message reminders?
Previous Address
Previous Address
Zip/Postal
City
Country
New Address
New Address
City
State/Province
Zip/Postal
Country

Other members of your family requiring a change of address (if registered here)