Lyme Bay Medical and Dental Practices
Kent House Health Centre, Silver Street,
01297 443399
Lyme Regis Medical Centre, Uplyme Road,
01297 445 777
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Home
News
Opening Times
Appointments
Prescriptions
Patient/New patients
Services
Dental
Do it Online
Contact Us
Appointment Request
Last Updated: 27/09/2019
Your Details
Name
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Date of Birth
*
Phone Number
Email Address
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Named GP (if known)
Appointment Details
Appointment With
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Any Doctor
Any Nurse
Male Doctor
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Appointment Date
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Any Day
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Appointment Time
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In the morning
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Reason for Appointment (Practice Staff other than doctors or nurses will read this)
THIS FORM COLLECTS YOUR NAME, DATE OF BIRTH, EMAIL, OTHER PERSONAL INFORMATION AND MEDICAL DETAILS. THIS IS TO CONFIRM YOU ARE REGISTERED WITH THE PRACTICE, TO ALLOW THE PRACTICE TEAM TO CONTACT YOU AND ALSO TO UPDATE YOUR MEDICAL RECORDS HELD BY THE PRACTICE AND OUR PARTNERS IN THE NHS. PLEASE READ OUR PRIVACY POLICY TO DISCOVER HOW WE PROTECT AND MANAGE YOUR SUBMITTED DATA.
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