Please find our Access to Records form below which is available for you to print off and complete. We will require you to bring this back to the Surgery in person.
Please ensure your name, date of birth, address and signature has been completed and your representative has completed their part of the form entirely. We will also need to know whether your representative cares for you and if so, whether they would like their information to be sent to Derbyshire Carers.
Please note there are two different levels of access, level 1 and level 2. If you require level 1, this covers booking, checking and altering appointments, checking if a prescription is ready and what has been prescribed and checking if a test result is back (however not what the result is). If you require level 2, this covers all of the above and access to all areas of your medical information, meaning your representative can speak on your behalf.
This will apply to anyone aged over 16 years.