Patient Consent

Ifyou would like a Relative or Carer is to have access to your confidential medical information, please complete the form below and return to us in person or email at

It is vitally important that this form is signed by you or. If for any reason it is felt the request is suspicious the practice with holds the right to ask for further information from the patient who the records belong to. if you wish to withdraw your consent at any time then please contact the practice.

Download the consent form HERE