Update your personal details

It is essential that we have your current contact details, and these are updated when any changes are made, such as changing mobile numbers or moving house.

We are also looking at alternative methods of communicating with our patients e.g. SMS/text/emails.

We would therefore be grateful if you could take a moment to complete the attached form. Thank you.

Please confirm the surgery you are registered to:

Full Name:

Date of Birth:

Address:

Mobile Telephone Number:

Landline Telephone Number:

Are you happy to receive communication from the Practice by:

Text Message

Telephone call: Mobile or Landline

By Post

The information provided on this form will be used to update your patient records. Further information about how Much Wenlock and Cressage Medical Practice handle your personal data can be obtained by viewing the Practice Privacy Notice.

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to Much Wenlock • Kingsway Lodge, Kings Street, Much Wenlock, TF13 6BL.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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