Test page – medical records and paperwork

There’s a fee for most paperwork. This is because GPs aren’t contracted or funded to do this work by the NHS. If there is a fee, our medical secretary will call you to let what it is, before we start processing your request.

Please fill in the online form below to request medical records and other paperwork, if you’re able to. This helps us to manage paperwork requests efficiently.

If you can’t fill in the online form then please bring us a hard copy letter with your name, date of birth, address, details of your request and your signature. This is to make sure we only release your confidential medical information to you. This can also be emailed to us.

Medical records and paperwork

First name

Surname

Date of birth

Please use format day/month/year e.g. 12/05/1979

Phone number

Address

House number or name

Street name

Address

Town or city

Postcode

What type of paperwork do you need?

Medical summary – a medical summary is often sufficient for most purposes and is free of charge. A medical summary lists any major health problems and diagnoses, details of your last six consultations with us, repeat medications, acute medications issued in the last three months, allergies and basic details such as height, weight and smoking history.

Full medical records – our medical secretary will call you, to discuss your request. First sets of medical records are free of charge, subsequent sets cost £50. If a third party requests your medical records they typically pay the fee.

Doctor’s letter

Form to be completed by a doctor

Soul & conscience letter to be excused from jury service

Immunisation record – these are free of charge

Witness letter

Date you need your records from

Please use format day/month/year e.g. 12/05/1979

Date you need your records to

Please use format day/month/year e.g. 12/05/1979

Please tell us why you need a doctor’s letter, who it’s for and what you would like it to cover

0 of 150 max words

Please upload the form you need the doctor to complete – we need this to accept the request

Maximum file size: 10MB

What’s the reason you can’t do jury service?

0 of 150 max words

Please upload a copy of your citation letter calling you for jury service – we need this to accept the request

Maximum file size: 10MB

Signature

Clear

Checkboxes

I consent to the practice collecting and storing my data from this form.

Privacy policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

If you are human, leave this field blank.

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