Show Side Menu
Live Well
Conditions A-Z
Local NHS Services
Contact Us

Next of Kin Details

Please complete this form if you are happy for us to update your medical record with your next of kin details and contact information. 

Next of Kin Details
Patient registered with us

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

Local Services, Let