In order to access online services, you will need to complete the following request form (Please complete all fields before printing - one form for each patient):

Patient Online Access Request

Bring this form together with

• Photo ID and an additional form of
• Proof of residence (bank statement, utility bill, council tax bill)

with you and hand it to reception.

PLEASE NOTE THAT ACCESS TO RECORDS FOR CHILDREN ABOVE THE AGE OF 11 IS RESTRICTED. PLEASE SPEAK TO STAFF AT THE SURGERY FOR MORE INFORMATION.