Update Personal Details

Let Us Know

Update Personal Details

Please let us know as soon as possible and use this form to update your name, address, contact details for yourself or dependants in case we need to contact you.

Please note: If your name has changed due to Marriage or by Deed Poll, please be aware that it is a requirement by the Department of Health for you to provide official documents to confirm this. Please attend the surgery with your documentation.

KAMP can dispense medications to patients living more than a mile from their closest chemist or pharmacy. If you move house to meet this criteria, you can chose to collect medications directly from KAMP.

If you have previously been a dispensing patient and you move to be within one mile of a pharmacy, we can no longer legally dispense to you and you will need to nominate a local pharmacy to collect from.

Complete The Form Below

Title
DD slash MM slash YYYY
Email
Do you give permission to receive SMS communications from KAMP eg for appointment reminders?
Previous Address
Current Address
Do you live within 1 mile (as crow flies) from a pharmacy ?
Other members of your family requiring a change of address (if registered here)
Name
Date of Birth
 
click on + icon to add more members of family