I wish to have access to the following online services
Please tick all that apply – Please note some of these services may not be available
I wish to access my medical record online and understand and agree with each statement below:
I will be responsible for the security of the information that I see or download
If I choose to share my information with anyone else, that is at my own risk
If I suspect that my account has been accessed by someone without my agreement, I will contact the practice as soon as possible
If I see information in my record that is not about me or is inaccurate, I will contact the practice as soon as possible
If I think that I may come under pressure to give access to someone else unwillingly I will contact the practice as soon as possible
Evidence of Identity
To register for Online Services we need to verify your identity. So, please provide the practice: One photo ID such as passport or drivers licence and one form of ID with your home address on such as a recent utility bill or bank statement.
Copies can be uploaded on this form or delivered to the practice.
How would you like to provide evidence of your identity?
Please upload your files to the practice here. We accept tiff, jpg, png, gif, txt, Word and pdf files, up to a total upload size of 5MB.