Change of Personal Details LS

Before submitting this form please check to make sure your new address falls within our practice boundary. If not you will need to register with a new surgery. 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, can you please provide us with a copy of the appropriate document (requirement of Department of Health).

Last Updated: 02/03/2021

Your Details





Change of Name



Change of Address

Please check your new postcode on the boundary map on our website before submitting your change request. If your new address falls outside our boundary you will need to register with another, more local practice.



Update Contact Numbers




Update Email Address