Consent to proxy access to GP online services

Use this service to provide consent for proxy access to medical records.

You can use this service if you:

• are registered at the surgery

Before you start

We’ll ask you for:

• your first and last name, date of birth, sex, postcode, email and phone number
• if applicable, the details of the person you are completing the form on behalf of
• 2 forms of identification for the patient and proxy

Start now

You can also phone us on Wychbury Medical Centre 01562 547300 or Cradley Road Medical Practice 01562 547300 or Chapel House Surgery 01562 547300.