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Hampshire Health Record
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Consent & Change of Personal Details

Consent to Share with Specified 3rd Party 

If you would like a relative, Carer or a nominated person to have consent to discuss your medical records and personal information with the practice please complete the form below. You can restrict what part of your medical record can be discussed, for example only give permission for a nominated person to order your prescriptions. Please be aware that this consent will remain in force indefinitely. However, your doctor may, at your request, override this authority to allow access to your medical records at any time.

Consent to Share with Specified 3rd Party Form


Change of Address

If you have changed address please complete the form below. Please check the Practice Area before submitting the form to make sure your new address is still within our boundary. If you move outside the practice area, please register at your local practice as soon as possible.  

Change of Address Form


Change of Contact Details 

It is very important that we have your correct details recorded. Please take a moment to complete the form below in order that we can update your records. If you are waiting for an appointment at a hospital or are under the care of a consultant, you will also need to inform them of your updated contact details. 

Change of Contact Details Form


Change of Name 

If you have changed your name, please complete the form below. Please be aware we NO longer need to see proof of name change. 

Change of Name Form

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