Use this service to provide consent for proxy access to medical records.
You can use this service if you:
- are registered at the surgery
- are requesting proxy access to a patients online services that is 10 years old or under
A new consent form will be required when moving into a new age bracket (11 to 15 or
16 and over).
Before you start
We’ll ask you for:
- your first and last name, date of birth, sex, postcode, email and phone number
- if applicable, the details of the person you are completing the form on behalf of
- 2 forms of identification for the patient and proxy
You can also phone us on 01384 460111.