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Appendix 1 – Application form for access to health records

APPLICATION FORM FOR ACCESS TO HEALTH RECORDS

in accordance with the General Data Protection Regulation (GDPR)

DATA SUBJECT ACCESS REQUEST

You will need to fill in a form to access your records for anything from blood results, copies of letters or full copies of your record. You can come into the surgery to collect the form or fill out a copy on the website (On the left) and send it into us.

This form must be completed in blue or black ink and signed in order for us to process your request.