Admin: ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist
Alcohol Audit C
Asthma Review
Change of Address
Communication Consent
Patient Health Questionnaire (PHQ-9)
Travel Vaccinations
Update Clinical Record

Key Information

About The Practice
Collective Action
Care Quality Comission
Courtesy
Data Choices
Extended Access Service
Friends & Family Test
General Data Protection Regulation
GP Net Earnings
Home Visits
New Patient Registration
Non NHS Services
Online Access
Patient Participation Group
Practice Policies
Services
Summary Care Record
Catchment Area
Vasectomy
URGENT MESSAGE UPDATE 17th December 2021
Coil and implant fitting and replacement

Live Well
Conditions A to Z

BBC Health News

Atlas of cells transforms understanding of human body20 Nov 2024 16:00Scientists are mapping out the 37 trillion cells of the human body and changing what we thought we knew
Drug hope to treat voice spasm like RFK Jr's20 Nov 2024 14:01Sodium oxybate can offer temporary relief, in a similar way to drinking alcohol, a trial suggests.
Streeting orders review to end 'toxic' NHS staff row20 Nov 2024 00:34The health secretary says fears over physician associates need looking at, but laments nature of debate.
BBC's Glenn Campbell: I want to show what it’s like living with a brain tumour20 Nov 2024 06:17BBC Scotland's political editor was diagnosed with an incurable cancer after having a seizure.
Women plan UK legal action over talc cancer claims20 Nov 2024 06:16Hundreds of women in the UK are taking legal action against Johnson and Johnson.
'Ambulance delays made me a widow at 28'20 Nov 2024 06:08Aaron Morris, 31, died following a crash in County Durham in 2022, but could have been saved.

Admin: Subject Access Request (SARs)

Please complete the form below if you wish to access your health record as set out in the General Data Protection Regulations 2018.

In Accordance with Article 12 of the GDPR 2016 - Copies of medical records will be made available to you within one month of your request (this period of compliance can be extended by a further two months where requests are determined to be ‘complex’ or ‘numerous’).

You will be expected to collect your electronic record(s) from the practice when they are ready – you will be informed by text or email.

We will require you to bring a photographic form of identification for Reception to check when collecting your medical records.

A reasonable fee based on the organisations administration costs may be charged for SARs in the following instances:

where further copies are requested by the data subject
or the request is manifestly unfounded, or excessive

Please do not write any clinical queries on this form. Any clinical queries or request for appointments via this form will be discarded. To make an appointment either book online via the NHS app/Patient access or by calling reception 01926 316711. We will start to process your form by the next working day but it will take up to 30 working days to complete. Please DO NOT call before 30 working days as you will not receive a status update from reception or the administrative team. If you are NOT a registered patient then your form will be discarded. This service is only for patients registered at the surgery aged 16 and over; and for parents or legal guardians of children. Forms must be completed in the UK due to GDPR regulations.

Admin: Subject Access Request (SARs)

Patient Name:

Date of Birth (DD/MM/YYYY):

Full Address:

Email Address:

I wish to access my health record as set out in the General Data Protection Regulations (2018). I wish to access:

Declaration - I decalre that the information given by me is correct to the best of my knowledge and I am entitled to apply to access my health recordsreferred to above under the terms of the Access to Health Records Act 1990. Please choose:

If a specific part of you medical record wanted please state further details to explain which part you require:

We can provide copies of your records in the following way: (Please select appropriate option)

I declare that the information given by me is correct to the best of my knowledge and that I am entitled to apply for access to the Health Records referred to above under the terms of GDPR 2018. (COMPULSORY: Please select appropriate option)

I am the patient

I have been asked to act by the patient and attach the patient’s written authorisation

I am acting in loco parentis and the patient is under the age of 16 years (and is incapable of understanding the request/has consented to my making this request).

Name and Contact Number (IF NOT the patient)

I also understand that no clinical opinion can be given with regards to viewing my health record as a clinician will not be available to oversee the viewing.

Medical Records Access Questionnaire

Have you read the Guide for Patients on viewing your medical records online?Link to document above

The system allows you to see a summary of your medical record: diagnoses, allergies, medications, recent consultations, letters to the GP and test results. Are you happy to view this information?

You need two passwords, one to book online appointments and the second to access your medical record. Keep them safe and secure. You should not share your passwords. Do you agree this is safe and secure enough?

You may see that a test result is reported as ‘abnormal’ or information about you that concerns you.

For example, you may have seen a hospital doctor who will write to your GP. You may read information in their letter that you do not understand or you find upsetting.

You may have a test done that shows something ‘bad’ that you were not expecting. (e.g. an x-ray report which shows you have a ‘shadow’ on your lungs). You may be reading these results/letters when the surgery is closed, in the evening or at the weekend, before the GP has accessed them.

How do you think you would you react in these circumstances?

Open results and make a routine appointment to see the doctor/nurse to discuss my concerns

Not view an abnormal result but make an appointment to see the doctor/nurse

Panic and get worked up if surgery is closed

Look at some of the recommended websites

Contact NHS Direct to get further information

Contact the Out of Hours Service

Other

If other please state:

Sometimes information may be recorded that is incorrect or there may be information that you think is missing. Would you inform the practice so that your records can be corrected?

Do you feel you have a better understanding of ‘Medical Records Access’ and what the issues are about it?

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to Whitnash Medical Centre • 110 Coppice Road , Whitnash, Warwickshire, CV31 2LT.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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