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  • 01702 420 642
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Scott Park Surgery
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Downloadable Forms

Type 1 Data Opt Out Form

Type 1 Opt Out Form (to be returned to the GP by 23 June 2021) (DOCX, 46KB)

Data Subject Access Request Downloads

Data Subject Access Application Form (PDF, 599KB)

Practice Information Leaflet

Download our Practice Leaflet (PDF, 173KB)

Patient Online Registration Downloads

Online Services Records Access (now a website link)

Download Application form for online access (PDF, 281KB)

Consent to proxy access to GP online services (now a website link)

Change Of Personal Details Form Downloads

Download the Change of Personal Details (PDF, 58KB)
Download the Change of Personal Details (DOCX 14KB)

PPG Downloads

Download our Active / Virtual PRG Contact Form (PDF, 311KB)

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Scott Park Surgery

205 Western Approaches, Southend-on-Sea, Essex, SS2 6XY

  • 01702 420 642
© Neighbourhood Direct Ltd  2025
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