Proxy Access To Medical Records

If you wish to grant access to somebody to be able to act on your behalf with regards to your medical records, we require this in writing.

To make this easier we have created a template which you can download below.

This access can be 

• Partial – Limited Access as specified by the patient
• Full Access

Examples of access include

• Making and Booking Appointments
• Requesting Medication
• Speaking on behalf of the patient e.g. during appointments without the patient present or on the phone.
• Requesting medical information such as test results and consultation notes

NB This does not override any power of attorney documents which are legally binding.

You will need to fill this form and sign it (Wet signatures Only) and return it to the practice who will reverify the information with the patient. If you have any queries, please email us at baconlane.surgery@nhs.net