Data Protection & Patient Health Record Information

Change of Personal Information

If you have changed your current address or any contact details (home number, mobile number, email address), it is imperative that you complete the form below and return to the surgery, to ensure your records are accurate.

Patient Information Amendment Form

Subject Access Request (SAR)

You have a right under the General Data Protection Regulation (GDPR) 2018 and New Data Protection Act 2018, to request access to view or to obtain a copy of information the surgery holds about you.  In order to request this please complete the form below and send it into the surgery. You will need to give adequate personal information so that your identity can be verified and your records located.We are required to respond to you within one month. 

Subject Access Request Form

Patient Contact Consent Form

If you currently receive, or wish to continue receiving SMS messages from us, please complete the form below and return it to the surgery, if you have not done so already.

Patient Contact Consent Form

Consent to Disclose Health Information

Due to changes in Data Protection Legislation, where you wish a third party (carer, spouse, relative or friend, etc.) to have consent  to all or part of your health records, please complete the form below and return to the surgery. It will need to be witnessed by somebody other than the third party.

They will need to provide their ID (debit/credit card, driving licence, passport, utility bill) and know your personal details (NHS Number, date of birth, full name) on every contact with the surgery, prior to our staff disclosing any information about you.

Consent to Disclose Health Information


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