Practice Online Access to Medical Records Consent Form

The Brunston and Lydbrook Practice offers patients facilities to view online, export or print any summary information from their record, relating to medications, allergies, summary of problems, and immunisations. We have the option to open your medical record for you to view using SystmOnline. If you would like to view your medical record, you will need to submit this consent form and provide our Care Navigation Team with your photo ID. Your medical record will be available for online viewing no later than 28 days from your request.

Online Access to Medical Records Consent

Section

Medical Record Access

I wish to have the following level of record access: *
*

Application for Online Access to my Medical Record

I wish to access my medical record online and understand and agree with each statement: *