Show Side Menu

Update Clinical Record

Please help us to keep our clinical records up to date by providing the information below.

1 Your Details

Please provide in the format dd/mm/yyyy
This will allow us to locate you quickly on our Patient Database.

2 Your Address

3 Your Contact Details

4 Physical Attributes

5Lifestyle Choices

6 Additional Information

Although sending information across the Internet means that privacy of data cannot be absolutely guaranteed, our online forms offer high levels of security. The forms use HTTPS and TLS (using a 2048 bit certificate) to encrypt data sent to and from your computer when using the site and our server environment is PCI DSS certified - the highest standard of security associated with e-commerce and online finance solutions.

Form submissions are stored on the server for 28 days and are encrypted and secured with a private key known only by the GP Practice.

Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

AXA Speedy Access Merely Theatre Shelf Pharmacy Ltd
© Neighbourhood Direct Ltd 2017
The Primary Centre - Horne Street, Halifax, HX1 5UA
Practice Website supplied by Oldroyd Publishing Group
AXA Speedy Access
Merely Theatre Shelf Pharmacy Ltd
Back to top