Change Personal Details

Change of Name

We are unable to take change of name requests and details by telephone.

This form must be completed and brought into St Mary’s Surgery.

When returning this form to the Surgery, please provide photo ID and relevant documentation.

Please complete the entire form in block capital letters.

You can download the form here or collect the form from our Surgery Reception.

Please be advised that your change of name may have implications for Hospital records. If you are seeing or waiting for an appointment with a specialist at a Hospital, you will need to contact the Hospital and advise them of your change of name.

Change of Address / Contact Information

It is very important that we have your correct details recorded.

Please take a moment to complete your name, address and current contact telephone numbers in order that we can update your records.

Please be sure to check that your new address is within our catchment area as you may need to re-register with another GP Surgery.

If you are seeing or waiting for an appointment with a specialist at a Hospital, you will need to contact the Hospital and advise them of your change of contact information.

This form must be completed and brought into St Mary’s Surgery.

Please complete the entire form in block capital letters.

Please be sure to give the full names, date of birth and contact telephone numbers for any other Patients involved.

You can download the form here or collect the form from our Surgery Reception.

When returning this form to St Mary’s Surgery, please be prepared to provide evidence of your new address, such as a utility bill or bank statement etc. and provide photo ID.