Access to Patient Medical Records

If you would like to apply for access to your records, please complete this form.

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).

Record required: *

Personal details of the patient whose records are requested

Please use format: DD/MM/YYYY

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

Please provide an email address for replies to be sent to:

Any responses we send will go to this email address

Please note that your request will be dealt with by your doctor within the next 21 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
Waltham Cross