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Change of Address, Name and/or Telephone number

We need to know as soon as possible if your address changes. You can print off the form below to notify us of your change of details (this may include other members of the household). Alternatively, you can fill out a form at reception. Please note, you will be asked to provide proof of i.d and your new address in order for us to amend your details.   

Change_of_Name_and_or_Address_form.docx 

If you move out of our practice area, we may have to ask you to register with a GP surgery closer to your new home.

In the event that you need to change your name we will need proof either in the form of a marriage certificate, change of name deed or origional birth certifiacte. 

Consent forms

If you would like to give permission for Stoke Road Surgery to release your medical information (appopintment details, test results, medication or any medical information) to a named person/s you can do so by completing a "Consent to release medical information to a nominated friend or relative".

Also, if you would like to receive text message/email reminders to confirm appointment booking or cancellations and general important health promotion information, (such as when flu clinics are being held), please complete a Text messaging and e-mail communications consent form.

More information to follow.

 
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