Change of name or address

Please be aware if you share your email account or phone with another person, we may contact you about this request via any of the contact methods provided by you.
Please select the information you are wanting to update?

Change of Name

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).

Change of Address

Update Contact Numbers and Email

Other Details

Not sure what your closest pharmacy is?

Use the NHS Find a Pharmacy tool.

Communication Needs

Text/SMS, Emails and Letters

You may receive information by letter and phone; however you must consent to receieve information by text/SMS or email. 

These details will never be provided to third parties. The information sent may be about appointments, results, referrals, messages about your specific health needs ( e.g. a flu vaccination reminder or a diabetic management plan) and general health information and updates that could benefit you. 

The responsibility for attending and cancelling appointments, managing prescriptions and obtaining results still rests with you though. We will record your preferred method of contact as SMS/text unless you write advising us otherwise or have ticked no in the boxes below. 

I consent to be contacted by Swadlincote Surgery by text: *
I consent to be contacted by Swadlincote Surgery by email: *
I consent to be contacted by Swadlincote Surgery by letter: *

Signature

The information recorded above is accurate to the best of my knowledge and I take full responsibility to inform Swadlincote Surgery of any changes in the future. 

I take full responsibility in ensuring that I have the appropriate secruity settings on any phone, tablet, and/or computer I use to maintain the privacy of the message.