Change of Details

Chawton House Surgery St Thomas Street Lymington Hants SO41 9ND Tel: 01590 672953

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Change of Personal Details

If you change your name, address or telephone number please let our receptionists know. Unfortunately if you do not keep us informed of your up-to-date contact details The Practitioner and Patient Services Agency (‘PPSA’) may automatically remove you from our patient list without our knowledge.

If you move outside the practice area it will be necessary for you to find a doctor in your new area.

The Practitioner and Patient Services Agency will help you if you experience any difficulty. The instructions regarding moving to another area are on your medical card.

The Practitioner and Patient Services Agency contact number: 01962 853361

Please note that if you are waiting for an appointment from a local hospital, then you must inform the hospital of your change of address.

Online Form to send us your change of details
Please Note: This form is sent to us via computers that do not belong to the NHS in a non-encrypted format. Complete confidentiality for this type of message can not be guaranteed.

* this information is essential	Old Details
(Previous) Name	*
(Previous) Address	*

(Previous) Post Code:	*
Date of Birth	*
Date of Change

	New Details
New Name	*
New Address	*

New Post Code:	*
Telephone Number

Other Family Members Affected by Change:
Name		Date of birth
1
2
3
4
5
6
7
8

Please indicate your smoking status *

Are you a carer for someone? Please give us the name and address of the person you care for.

Does someone care for you? Please give us the name and address of your carer.