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Changing Your Name
Please use this form to update/change any part of your name
We do require proof of name change such as a deedpole or passport. If you cannot provide proof, please state reason below.
Note:
If you are looking to change your TITLE from Mr to Miss/Ms/Mrs or Miss/Ms/Mrs to Mr - please see our LGBTQ+ page regarding name changes, as changing your title to a different gender, would mean we would need to change your gender on your medical records and issue you a new NHS number too.
Privacy Consent
This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.
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PRACTICE ADDRESS
Amersham Vale Practice
Suite 5
Waldron Health Centre
Amersham Vale
London
SE14 6LD
Out of Hours: 111
ARMED FORCES ACCREDITED
SUPPORTING THE LGBTQ+ COMMUNITY
