APPLICATION FOR ONLINE ACCESS

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You can now order repeat prescriptions and see information in your GP records, including medications and allergies online.

The surgery has a responsibility to look after your GP records.

You must also take care online and make sure your personal information is not seen by anyone who should not see it.

Keeping your username and password safe

When you register to use Online Services, you will create your own username and password, which you will use to log in. You should not share your log in details with others.

To protect your information from other people:

  • You should keep your password secret and it is best not to write it down. If you must write it down, keep a reminder of the password, not the password itself. This should be kept in a secure place.
  • If you think someone has seen your password, you should change it as soon as possible. You may want to call the surgery if you are not able to change it right away, for example, when you do not have access to the internet.
  • You should not share your user name or password. No one should force you to show them your log in details, you have the right to say no. If someone forces you, tell the surgery as soon as possible.
 
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Using a shared computer

You need to take extra care when using a shared computer to look at your records online.

This could be at the library, at work, at university or at home.

To protect your personal information from others when using a shared computer, you should:

  • Look around to see if other people can see what is on the computer screen. Remember, your records contain your personal information.
  • Keep your username and password secret. Just like your bank account PIN you would not want others to know how to get into your records.
  • Make sure you log out when you finish looking at your records so that no one else can see your personal information or change your password without your knowledge.
 
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Incorrect information in your records

On rare occasions information in your records might be incorrect.

  • If you find any incorrect information you should let the surgery know as soon as possible by submitting an Admin Query via our online consultation system.
  • If you see information about anyone else in your records, log out immediately and let the surgery know as soon as possible.
 
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  • Patients under the age of 13 cannot have their own account
  • Patients over the age of 13 must have their own personal email account which cannot be shared
 
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Details of the Patient
Please double check you've entered the correct email address
Details of the applicant(s)
 
 

Should you need additional applicants, please submit another form once completing this one

Access to the the following is required on behalf of

If you are making an application on the behalf of somebody else we require evidence of your Authority

Please upload a copy your supporting documents

  • You can upload a document, photo or scan

We require evidence of your Authority or Birth Certificate

Please upload a copy your supporting documents

  • You can upload a document, photo or scan
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx
 
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Proof of Identity

Identification

We are required to check the identity of all applicants.

Acceptable forms of Photo ID

  • Photo Driving License
  • Passport
  • ID documents are not stored and will be securely destroyed in line with our data retention schedule.

Acceptable forms of Proof of Residence

  • Tenancy agreement
  • Mortgage statement
  • Bank statement
  • Utility bill (date within the past 3 months) 

Please upload a copy of ID and Proof of Address for the patient.

  • You can upload a document, photo or scan
Please upload a copy of your ID and Proof of Address
  • You can upload a document, photo or scan
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx

Please upload a copy of ID and Proof of Address for - Applicant 1.

  • You can upload a document, photo or scan
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx

Please upload a copy of ID and Proof of Address for - Applicant 2.

  • You can upload a document, photo or scan
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx
 
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To be completed by the Patient

I give permission to my GP practice to give the applicant (s) proxy access.

Proxy access will be given to the following online services:

  • Booking appointments: 
  • Requesting repeat prescriptions: 
  • Access to my medical records: 
  • Access to test results: 
Patients requiring access to their own record
Proxy declaration

As the lead applicant, I agree to the following and sign.

Privacy Consent

 
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