View Your Medical Record Online

If you would like to view your medical record online we will require you to fill out the following form.

This can be done by filling out the form below or by downloading a copy here and handing it in at Reception.

1Details of the record to be accessed

2Details of the person who wished to access the record (if different from above)

Declaration: I declare that the infomation 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 the data protection act 1998

3What level of access are you applying for


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 known only to the GP practice and is accessed over a secure connection by nominated Practice staff. Our practice has a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

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.


Your Neighbourhood Professionals. Just a Click Away!
Park View Centre, Chester Road North, Brownhills, WS8 7JB
Website supplied by Oldroyd Publishing Group
Your Neighbourhood Professionals. Just a Click Away!
Back to top