High Field Surgery
Holtdale Approach, Leeds LS16 7RX

Change of address and telephone number form

It is important that we keep our records up to date regarding your address and telephone number. If you wish to update these details please feel free to use this form. Remember that our practice area covers all of the LS16 postcode and the LS18 postcode above the A6120 ring road.

 

Change of address form

Please enter the names of all people living in your house so we can update every person's details

Your name(s)
Your old address Type your old address here

New address details

New telephone number

Please remember that our practice area covers all of the LS16 postcode and the LS18 postcode above the A6120 ring road.

Your new address Type your new address here

 

Disclaimer

If you elect to use this form please remember that if you enter information about yourself it will be sent to us across the Internet. This information will not be encrypted but will be no less secure than a normal email. Please be aware that we cannot guarantee that this information will not be seen by others.