Change of address

Change of address
PLEASE NOTE:

Unless you are graduating, please do not give us an address outside Southampton.

If we input an address outside Southampton, you will be de-registered and have to re-register again when you return to Southampton. This creates a huge amount of additional work for the practice and means you will not be able to access a doctor before re-registering.

However, if you are permanently leaving Southampton, please tell us your new non-Southampton address.

Thank you.
Do you consent to us collecting your data using JotForm (a secure, GDPR-compliant, EU-based form software provider)?*

Yes, I consentNo, I do not consent

Your new Southampton address
If you're unsure of the post code, please use Royal Mail Postcode Finder to locate it.
Tell us you are leaving Southampton
Please use this option only if you have no intention of returning to Southampton.

Otherwise, please tell us your next Southampton address instead!
Please confirm:*

I am permanently leaving SouthamptonI will return to Southampton next academic year (please click BACK!)
Line 1:*
Line 2:
Line 3:
District:
City:*
Postcode:*
Country:*

Your new Southampton address