Only use this form if you are a Registration Authority (RA) manager requesting a change to the information on the primary care service provider contact details page.
Do not use this form if you are:
- not an RA Manager
- trying to unlock your smartcard - instead, use self-service smartcard unlock
- trying to find your RA - instead, use find your Registration Authority
- looking to change an organisation's RA function in any way - instead, open a ticket with the National Service Desk
Completing this form
Give as much detail as you can in the 'Requested change' section, including any changes of:
- named contact or RA provider
- address
- telephone
- website
- RA provider
Required form fields
Fields marked with an asterisk (*) need to be completed before the form can be submitted.