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.

Please note: If your name has changed due to Marriage or by Deed Poll, please provide us with a copy of the appropriate document (requirement of the Department of Health).

Required field(s) are indicated by *
Change of name or address

Change of name or address

About you

As it appears on your passport.

As it appears on your passport.

The one used to register with your GP.

Your date of birth is required to verify your identity.

As on your medical record.
This phone number will be used for all correspondence relating to this request.

This email address will be used for all correspondence relating to this request. Please be aware that if you have given anyone else access to your email account they may see responses sent to you.

Please continue completing the form below
Please select the information you are wanting to update?
To complete the request, please upload a copy of the appropriate document, e.g. Marriage certificate or proof of new address.