Update patient details and preferences

Update your details and preferences

Keeping your details up to date helps us contact you quickly about appointments, results, and prescriptions.

This secure form takes less than 1 minute to complete.

SECTION 1: Patient Identification

Used to ensure we update the correct patient record.

Full Name *

Date of Birth *

Post Code *

Address

SECTION 2: Contact Details

Used for appointment reminders and important updates. Helps us contact you quickly and avoid delays.

Mobile Number *

Email Address

Section 3: Online services

Use our online services to save time and avoid queues.

You can:

Order repeat prescriptions

Book and cancel appointments

Are you registered for online services (Patient Access)?

Yes - I already use online services

No - I would like to register

Not sure

Please send me instructions to register for online services

Yes

SECTION 4: Preferred Pharmacy

Your prescriptions can be sent directly to your chosen pharmacy – no need to collect from the practice.

Select your nominated pharmacy

Section 5: Carer Information

This helps us provide appropriate support and ensure you receive the right care.

Are you a carer or cared for?

I am a carer

I am cared for by someone

Neither

I would like information about support available for carers

Yes No

SECTION 6: Confirmation

Your information is securely stored and used only for your care at Kensington Medical Centre.

I confirm these details are correct and can be updated on my medical record *

Yes No

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