E Mail & Text Consent Form

E Mail & Text Consent Form

Your Details

Name

By using Our site, you consent to such processing and you warrant that all data provided by you is accurate. Your registered e-mail address will be used by Newbyres Medical Group GP practice to send reminders and notifications. If you are sharing an e-mail address, those reminders and notifications will be viewable by any user of that shared e-mail address.

I consent

Date of Birth
For example, 15 3 1984

Day

Month

Year

Mobile Number

Email Address

THIS FORM COLLECTS YOUR NAME, DATE OF BIRTH, EMAIL, OTHER PERSONAL INFORMATION. THIS IS TO CONFIRM YOU ARE REGISTERED WITH THE PRACTICE, TO ALLOW THE PRACTICE TEAM TO CONTACT YOU. PLEASE READ OUR PRIVACY POLICY TO DISCOVER HOW WE PROTECT AND MANAGE YOUR SUBMITTED DATA.

I consent to the practice collecting and storing my data from this form.

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Page last reviewed: 02 July 2025