Eastgate Surgery
01582 957 599
[email protected]

Update your details

If you change name, address or telephone number, please let our receptionists know by calling or writing to us. Alternatively you can complete the online form. If you move outside the practice area you may need to find a doctor in your new area. There are instructions on what to do when you move to a new area on the back of your NHS medical card.

This form allows you to update your contact details and those of your household.
Email(Required)
DD slash MM slash YYYY
DD slash MM slash YYYY
When would you like us to update our records?
NHS number should be in the form nnn-nnn-nnnn for example: 123-456-7890
Sex(Required)
Old address
New address

Other members of the family

Other members of your family requiring a change of address (if registered here)
Name 1
DD slash MM slash YYYY
Name 2
DD slash MM slash YYYY
Name 3
DD slash MM slash YYYY
Name 4
DD slash MM slash YYYY
Consent(Required)
This field is for validation purposes and should be left unchanged.