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Change of GP Request Form

Change of GP Request Form – privacy and web systems disclaimer


Data protection information – please note

The information that you submit on this web form will be processed by Microsoft 365 (NHSmail O365 Shared Tennant) and held on Microsoft Forms. Once processed by Microsoft 365 we will transfer the data from Microsoft Forms onto our own internal IT network drives and hold it for 12 months before deleting it (this is to aid our internal review processes and assist with changing GP). 
For more information on NHSMail 0365 Shared Tennant security measures please see
follow this link.


Please only use the submission form if you are happy with this information.
If you are not happy for your information to be processed using this submission form, please make your request in writing to the surgery. Note you must include the following information on your request: First Name, Surname, DOB, Address, your current GP and a paragraph providing as much detail as possible as to why you would like to make the request. We will unfortunately not be able to process requests missing any of this information. 

 

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