Patient Information Update

We need your email address and mobile number

Crawley Down Health Centre are currently collecting mobile phone numbers and email addresses of our patients. This information would be helpful for several reasons - we can remind you of your appointments at the surgery and we can also send out reminders for periodic medical reviews that might be due and specific to you. If you are happy to provide us with your contact details for this purpose, Click Here to Download the PDF Form (PDF, 75KB) and drop it into the surgery or complete the form online below.

Consent to speak to a 3rd party

So that we can leave messages with friends/family should we not be able to contact you or so that they are able to request results etc on your behalf, we need you written consent. Please download the file below and return it to a receptionist.

Consent Form - Download (.docx)

Patient Information Update





Please confirm by clicking YES or NO in the relevant sections below to indicate whether you are willing for the information to be used by The Crawley Down Health Centre, as a means of contacting you. Should you have any queries, please contact the Health Centre on 01342 713031

Resident No. 1

Resident No. 2

Resident No. 3

Resident No. 4

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.

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