Proxy Access & Online Registration Form
Online access is available to all patients who are 16+. To set up an online account, please visit our online section.
Proxy access may be granted to a third party if a patient consents and it is deemed to be in their best interests.
Our Practice policy is that proxy access is only granted for patients under the age of 11. Please note that proxy access will be suspended when the patient turns 11. If you would like this to be extended at this stage, you will need to make a further application to the Practice for this.
Child Under 11
For proxy access for a child under 11, please complete the form below. Proxy Access will be set up within 2 weeks of receipt of the request.
For patient’s aged 11+, the Practice default position is that proxy access will not be granted. The Practice will consider proxy access requests for patients 11+ but please note this will only be granted in special circumstances and if it is deemed to be in the patient’s best interests.
Over 16 Years old or Parent of 11-16 Year Old Child
If you are over 16 or are a parent/guardian of a child aged between 11 and 16 and wish to apply for proxy access to online records, please complete the attached ‘Proxy Access Application Form’ and hand this into Reception. This application will then be reviewed by the Partners and a decision regarding the application will be given within 2 weeks. If proxy access is denied, a reason will be provided to the person who submitted the application. Please note any decisions made regarding proxy access are final and cannot be appealed.
If proxy access is granted, please note this will only be withdrawn if the patient requests this in writing or if an exception arises.
The exceptions are:
- Patient is under 16: proxy access will be automatically withdrawn when patient turns 16 and a new application for proxy access will need to be made.
- Patient lacks capacity: a review of the proxy access will take place if a change in capacity is deemed to have taken place (i.e., patient reacquires capacity).
- Patient loses capacity after proxy access is given: a review of the proxy access will take place if a patient is deemed to have lost the ability to consent after proxy access has been given.
Application Form For Proxy Access To GP Online Services
Note: If the patient does not have capacity to consent to grant proxy access and proxy access is considered by the Practice to be in the patient’s best interest Section 1 of this form may be omitted.
- Patient making request – complete section 1, 3 and 4
- Representative making request – complete section 2, 3 and 4. Please upload proof of identification and address (e.g. passport, driving licence, utility bill)