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Third Party Access Sharing of Information Consent form

In order to protect confidentiality we usually insist that patients contact us themselves to discuss medical matters or to receive test results and other information.  However, we do understand at times that this may not be possible.

We require proof of identity to enable us to grant access to information sharing.

Please bring this form in to us along with one form of photo ID (e.g. passport, drivers licence, bus pass etc.).

Should the patient lack mental capacity we would require a copy of the Lasting Power of Attorney for Health & Welfare in order to grant access.

To download the form please click the link below:

3rd party access consent form

 

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