Consent for third parties to access medical records

Use this service to register a third party for representation.

In order to verify your request, you may be contacted by telephone to confirm your identity. Please note, in some instances you will be required to provide identification to the practice.

You can use this service if you:

• are registered at the surgery

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

Start now

You can also phone us on 01543 416633.