To whom it may concern letters

These can be needed for all sorts of reasons so please put as much detail in your request as possible please. There is a fee of £40 for doing this for you and please allow up to 28 days for the GP to do this non-NHS work.

Please select the practice location most relevant to this Online Form submission:

Name

Address

Tel number

Please complete the box below with as much detail as possible for your request

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.

I consent to my information being used for the purposes described above and wish to submit this online form to Emsworth Medical Practice • North Street, Emsworth, Hampshire, PO10 7DD.

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.