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Thanks for submitting the form.


Someone from our GP Practice will get in touch with you shortly. 

I wish to have restricted access my patient records (tick all that apply)
I DO NOT wish to have access to the following online services

Terms and Conditions:

  • I have read and understood the information leaflet provided by the practice

  • 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, this is at my own risk

  • I will contact the practice as soon as possible if I suspect that my account has been accessed by someone without my agreement

  • If I see information in my record that is not about me or is inaccurate, I will contact the practice as soon as possible

  • I consent to be contacted by the practice via text messaging service where appropriate

If you wish to restrict your access to online records, you will need to let us know. By restricting your access to your full records, you are still able to have access to make appointments, order repeat prescriptions, view your coded medical records. Please complete this form

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