Child (10 and under) consent to proxy access to GP online services

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
Start now

You can also phone us on 01384 460111.