Subject Access Request Form – Access to Medical Records

Requests for access to medical records can only be accepted and processed on this form for patients over the age of 11.

Access to online medical records for children under 11 should be requested using the Proxy Access Form.

Personal information collected from you by this form, is required to enable your request to be processed, this personal information will only be used in connection with the processing of this Subject Access Request. By completing this form, you are making a request under the General Data Protection Regulation (GDPR) for information held about you by the practice that you are eligible to receive.  All requests are subject to approval by the GP.

PLEASE ALLOW UP TO 1 MONTH FOR COMPLETION

Please hand your completed form in to Reception or email it to [email protected]

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