Please help us to keep our clinical records up to date by providing the information below.
PLEASE NOTE THIS IS NOT FOR CHANGE OF NAME – please click here for the Change of Details page where you can download the relevant form for these changes and bring it to reception with the required ID
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 known only to the GP practice and is
accessed over a secure connection by nominated Practice staff. Our practice has 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
Shotfield Medical Practice
Shotfield, Wallington, Surrey, SM6 0HY.
Should you have any concerns about sending your personal details using the web,
please use one of the alternative methods offered by our organisation.