Please find below various patient forms that can be printed off:
Consent to Share Confidential Information with a Third Party
The Data Protection Act 2018 and the ethical codes of conduct of all health care professionals require that medical data be treated with great respect for confidentiality. We are not permitted to share any medical details with a third party without your consent. If you wish to give a carer or third party consent then please print and complete the form below, this can be brought into surgery for your records to be updated.
Consent to Share Confidential Information with a Third Party (DOCX, 25KB)
Online Access
Under 11yrs old
Parents can have full proxy access up to 11yrs old to all services. When the child reaches the age of 11 it will be restricted to only online appointments, repeat prescription requests and summary care record. To Register for online services for a child under 11yrs old please complete the following form:
Patient online access - Under 11 years old (DOCX, 505KB)
11 – 16yr old
Restricted proxy access to online appointments and repeat prescriptions only. If parents are requesting additional access rights then the child would need to be assessed for competency. The child can have their own access or grant proxy access to parents if there are deemed competent by the GP (taking into consideration coercion and understanding this will be in place until they turn 16yr old or they request removal of services). This will be assessed on a Case by Case basis. When the child reaches 16yrs old the proxy access will be switch off and the child should be given their own access which should be applied for using the over 16yrs form.
Proxy Access form to be completed by both parent and Child, and both must present with completed form and ID. To request access for your child who is aged 11-16yrs of age please complete the following form:
Proxy access consent form (DOCX, 23KB)
Over 16yrs old
Own access unless patient lack capacity as determined by the GP. All patients over the age of 16yr should complete the following form to request access to online services.
Patient Online registration form (DOCX, 504KB)
Patient Online Proxy consent form (DOCX, 29KB)
New Patient Registration Forms
Select the following link for further information: New Patients page.
New Patient Registration form download.
Update Your Details
Select the following link for further information: Update your details page.