Accessing your patient record

You will appreciate that health data relating to any individual is highly confidential and the Practice must ensure that it releases such data only to the person to whom it relates, or to a person authorised to act on his/her behalf. Please complete this Request Form as fully and accurately as possible to enable us to locate the exact data you require. If you do not need access to your entire records, it would be helpful if you would inform us of the periods and parts of your health records that you require, along with details which you may feel have relevance (e.g. Clinic type, location, dates).

Proof of Identity

Two forms of identity must be provided (one of which must be photographic). This is to ensure no information is released to unauthorised individuals. The proof of identity required for each type of application is outlined below.

Patient applying for their own

Can be waived if the applicant is known to the Staff Member accepting the request.

Identification Required:

• One form of photographic ID (e.g. passport)
• One document containing the individual’s name and address

Third Party Applying

Consent of the Patient will be required BEFORE the request will be processed.

Identification Required:

• One form of photographic ID of the Third Party
• One document containing the Third Party’s name and address

Applying on behalf of a child

In Scotland the age of consent is 12. We will ALWAYS obtain consent for release of records from a child age 12+ to <16 if a third party is making the request.

Identification Required:

• Child’s birth certificate
• Photographic ID of the person with parental rights

If you are completing this application on behalf of another person, the Practice will require their authorisation before we can release the data to you. The person whose information is being requested should sign the relevant section within the form.

If the patient is a child (i.e. under 16 years of age), the application may be made by someone with parental responsibilities – in most cases this means a parent or guardian. If the child is capable of understanding the nature of the application, his/her consent should be obtained or, alternatively, the child may submit an application on their own behalf. Children will, generally, be presumed to understand the nature of the application if aged between 12 and 16. All cases will be considered individually.

Once completed please drop the form off at the Practice or email the completed form to ggc.gp43542clinical@nhs.scot

Thank you for your understanding.