Access to patient medical records

Under the Data Protection Act (1998) patients have a right of access to health records kept about them from 1 November 1991.

There are partial exclusions in the Act particularly with regard to information held on children, deceased patients and in cases where the doctor believes that disclosing information is likely to cause harm to the patient or any one else involved.

You will normally be invited to view your records at the practice. A doctor will be available to answer any queries. Photocopies of records are available (currently 50p per sheet to a maximum of £50).

Name of doctor usually seen: *

Record required: *

I wish to apply to inspect my written medical records held by High Street Surgery from 1 November 1991.

I wish to apply to inspect the written medical records of the patient named below, held by High Street Surgery from 1 November 1991 and attach a letter authorizing me to do so.

Personal details of the patient whose records are requested

Section

Address: *

Date of request:

Details of person requesting the information (if different from above)

Full Name:

Address:

Relationship to the patient:

Date range of the records being requested

Date of records requested from:

Date of records requested to:

Any relevant department/s:

Please note that your request will be dealt with by your doctor within the next 60 – 90 days. The Act does not allow other members of staff to provide this information.

Please send your relevant documents once this form has been completed to:
Practice Manager
High Street Surgery
13-15 High Street
Cheshunt
Waltham Cross
Herts
EN8 0BX

Tell us whether you accept cookies

Personal details of the patient whose records are requested

Section

Details of person requesting the information (if different from above)

Date range of the records being requested