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

Although sending information across the Internet means that privacy of data cannot be absolutely guaranteed, our online forms offer high levels of security. The forms use HTTPS and TLS (using a 2048 bit certificate) to encrypt data sent to and from your computer when using the site and our server environment is PCI DSS certified - the highest standard of security associated with e-commerce and online finance solutions.

Form submissions are stored on the server for 28 days and are encrypted and secured with a private key known only by the GP Practice.

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!
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Park View Centre, Chester Road North, Brownhills, WS8 7JB
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Your Neighbourhood Professionals. Just a Click Away!
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