Proxy Access to GP Online Services

If you would like to register for proxy access to GP online services, please complete the online form.

We request that patients upload photographic proof of ID and a recent utility bill.

Proxy Access to GP Online Services

Proxy Access to GP Online Services

Patient Details

This is the person whose records are being accessed
Does the patient have the capacity to grant proxy access? *

Patient Consent

I have read and understood the following conditions: *


These are the people seeking proxy access to the patient's online records, appointments or prescriptions
Any responses from the practice will go to this email address

I/we wish to have access to the following online services (Please select all that apply):

*Please allow two working days for your electronic access to be activated.

Please note you will need to verify your identity with two forms of identification, one must contain a photo and one must contain address details. Acceptable documents include passports, photo driving licenses and bank statements, utility bills (not mobile telephone bills).

If you need any further information or assistance with this matter, please ask at reception.

Application for online access to my medical record

I/we wish to have access to the patient's medical record and have read and understand the following: *
File Upload
Maximum upload size: 67.11MB