Register – Proxy Access

Proxy Access & Online Registration Form

Online Access

Online access is available to all patients who are 16+. To set up an online account, please visit our online section.

Important Notice

Proxy access may be granted to a third party if a patient consents and it is deemed to be in their best interests.

Practice Policy

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.

Children 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.

Children 11+

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If proxy access is granted, please note this will only be withdrawn if the patient requests this in writing or if an exception arises.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    • Patient is under 16: proxy access will be automatically withdrawn when patient turns 16 and a new application for proxy access will need to be made.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)

Section 1 - Request for Proxy Access By Patient


I give permission to my GP practice to give the above named person / people proxy access to the online services as indicated below in Section 3.

I reserve the right to reverse (in writing) any decision I make in granting proxy access at any time.

I understand the risks of allowing someone else to have access to my health records.

I have read and understand the information provided above on this page regarding Proxy Access.

Section 2 - Request for Proxy Access By Representative(s)

For the below patient of Manor View Practice:

Section 3 - Services

*Summary Care Record (SCR) gives access to a summary of the patient's allergies and drug sensitivities, acute medication and repeat medication

**Detailed Coded Record (DCR) gives access to a summary of the patient’s demographics, allergies/adverse reactions, drug sensitivities, acute and repeat medication, immunisations, test results, coded problems, diagnoses, procedures, coded referrals and letters received (excluding free text, letters and attachments, administrative items)

Section 4 - Reason For Requesting Proxy Access

What happens to my information?

Personal and medical information about patients registered at this practice are primarily kept electronically, although some is kept in paper form. Some information will be sent to hospital consultants and other health professionals to whom you are referred by your GP in order to provide continued healthcare and obtain treatment for you.

We sometimes use accredited suppliers for our communication with you, for example when we send recall letters for review clinics or medication reviews. All suppliers we use are checked carefully to ensure they comply with strict confidentiality protocols.

To ensure the security of all patient information, all staff that have access to your records are covered by confidentiality clauses in their contracts and the Data Protection Act and the Freedom of Information Act. Our guiding principle is that we hold your records in strict confidence.

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.