Summary Care Record (SCR) – Opt Out

Opting Out

The purpose of SCR is to improve the care that you receive, however, if you don’t want to have an SCR you have the option to opt out. If this is your preference please complete the form below to notify us of your decision.

SCR Opt Out Form

Patient Details

Consent

Privacy Policy

The information you supply us will be used lawfully, in accordance with GDPR Regulations. GDPR gives you the right to know what information is held about you, and sets out rules to make sure that this information is handled properly.

Please note that by using this form you will be sending information about yourself across the Internet. Whilst every effort is made to keep this information secure, you should be aware that we cannot offer any guarantees of absolute privacy. If this matter concerns you then you should use another method of application.

Personal information retained on this system is stored in a secure data centre located in the UK and is treated as confidential.  

Please read our Privacy Policy to discover how we protect and manage your submitted data.

Declaration

I declare that information given by me is correct to the best of my knowledge and that I am entitled to apply for access to the health record(s) referred to above, under the terms of the Access to Health Records Act (1990) / Data Protection Act.

If you are filling out this form on behalf of another person, please ensure that you fill out their details above; you sign the form above and provide your details below: