Who Can See My Health Record Form

Dear Patients

Please complete this form to ensure that your health data is shared appropriately for direct patient care.  The boxes on this form relate to two important areas - 

Box A - relates to the Summary Care Record (SCR) with the ability for additional information.

Box B - relates to data sharing between the GP Surgery and other agencies involved in direct patient care, e.g Health Visitors, GP+, School Nurses and Physiotherapists.

You can download a copy of the form below or alternatively ask for a copy when you are next in the Surgery.

Who Can See My Health Record



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