Change of Address Form- Outside the Practice Area

From January 2015 Kingskerswell and Ipplepen Medical Practice are able to keep existing patients who decide to move outside of the practice area. However, the practice is under no obligation to provide home visits when the patient is unable to attend the Health centre. The registration of a patient who lives outside the practice area has to be cleared by a GP as being clinically appropriate.

For the GP to assess whether your change of address is appropriate please complete the following information:

Full Name

Old address and Postcode

New Address & Postcode

Telephone Number

Mobile Number

Email Address

Preferred Chemist

Consent for storing submitted data

Important:

Change of Address Form- Outside the Practice Area