Tell us about a change to your details
Use this form if you have changed your name, address, phone number or email address. It takes about 3 minutes.
Fill in one form for each person. For a child, fill it in about the child.
This form is not checked for urgent problems. If you need medical help, see appointments or call 111.
Only your name, date of birth, what has changed and the declaration must be filled in.
Proof we will ask for
- New phone number or email address: we will need to see photo ID.
- New name or corrected date of birth: we will need to see proof, such as a marriage or civil partnership certificate, deed poll or birth certificate.
After you send this form, we will contact you about how to show us your proof.
This online form needs JavaScript. Please tell us about your change at reception or by phoning 01328 701568 instead.
[DEMO: this form is not yet connected to the practice's secure email service, so answers are not sent.]
There is a problem
Thank you, we have your new details
Your reference is . Please quote it if you contact us about this change.
We will update your record. If you have changed your name, date of birth, phone number or email address, we will contact you about seeing your proof first.
Page last reviewed: 30 October 2026