Application for online access

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What is Patient Online?

Patient Online services will give you the option to:

  • Make appointments online
  • Order repeat prescriptions online
  • View your own medical record online

You will be able to complete these actions using a computer, tablet or smartphone rather than having to phone or visit your practice.

Proxy Access will let patients access medical services for a child, or someone else they care for. Once a GP has set up proxy access, a patient can use the linked profiles feature in the NHS App.

What are the benefits of online services?

Online services will allow you to book and cancel appointments or request repeat prescriptions at a time that is convenient to you – day or night. It can also mean not having to travel to the surgery and can free up phone lines for people without access to a computer.

Having access to records means, that you could be more in control of your health and well-being. This is particularly helpful for people who live with a long-term condition such as Diabetes that needs regular monitoring and frequent prescriptions.

Practices tell us that online access helps to manage appointments and telephone calls more efficiently and patients find it convenient and accessible.

How can I be certain that no one else can get access to information from my GP record?

Only you will be given access to your record. When you sign-up to Patient Online, you will be given a secure login and a password.

These details are unique to you and, along with your personal information, will not be shared with anybody else unless you choose to let them see it. This is not different to how you would access other online services, for example banking.

Things to consider

Forgotten history

There may be something you have forgotten about in your record that you might find upsetting.

Abnormal results or bad news

If your GP has given you access to test results or letters, you may see something that you find upsetting to you. This may occur before you have spoken to your doctor or while the surgery is closed and you cannot contact them.

Choosing to share your information with someone

It’s up to you whether or not you share your information with others – perhaps family members or carers. It’s your choice, but also your responsibility to keep the information safe and secure.

Coercion

If you think you may be pressured into revealing details from your patient record to someone else against your will, it is best that you do not register for access at this time.

Misunderstood information

Your medical record is designed to be used by clinical professionals to ensure that you receive the best possible care. Some of the information within your medical record may be highly technical, written by specialists and not easily understood. If you require further clarification, please contact the Practice for a clearer explanation.

Information about someone else

If you spot something in the record that is not about you or notice any other errors, please log out of the system immediately and contact the Practice as soon as possible.

If you would like to register for this online service go to the next page to complete the process

  • You will be asked to provide a valid form of identification, for example photo ID or your Passport, Driving Licence or Birth Certificate.
  • Once you are registered the practice will email you the information that will enable you to create a username and password.
 
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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.Look around
  • 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.
  • 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 16 cannot have their own account
  • Patients over the age of 16 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 Full 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

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 's ID and Proof of Address

  • 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 's 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
Only following file extensions are allowed: jpg, jpeg, png, webp, pdf, doc, docx, pptx

Please upload a copy of  's 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
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 following people 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: %%form-element-12994%
Patients requiring access to their own record
Proxy declaration

 , as the lead applicant agree the following and sign.

 
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Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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