Get Patient Access To Medical Records - Request Form - Bournbrook ...

Filling out the Patient Access To Medical Records - Request Form is an essential step in obtaining your health records. This guide will provide you with clear, step-by-step instructions to ensure that you can complete the form accurately and efficiently online.

Follow the steps to complete your request effectively.

1. Use the ‘Get Form’ button to obtain the Patient Access To Medical Records - Request Form and open it in your preferred document editor.
2. Begin with Section 1, where you must provide the identity of the individual for whom the records are being requested. Fill in the full name, former names, current address, former address (with dates of change), date of birth, NHS number (if known), contact phone number, and optional email address. Select your preferred method of contact from the available options.
3. Move to Section 2, where you will indicate what records you are applying for by ticking the appropriate boxes. You can request test results, immunizations, or specific parts of the health record. If applicable, use the space provided to give additional details that may assist in your request.
4. In Section 3, provide your details if you are not the person requesting the records. Complete the surname, title, forename(s), address, telephone number, and email address. Confirm your authority to request the information by ticking the appropriate box.
5. Proceed to Section 4, where you will prove your identity. Choose between the options provided for how proof of identity has been confirmed, indicating whether you are attaching documentation or utilizing a countersignature.
6. Attach the required identity documentation as outlined in Section 4A, depending on your status as the applicant or representative. Ensure you include all necessary documents to avoid delays in processing.
7. Review all filled sections carefully, ensuring that all required fields are completed. Sign and date the declaration, adhering to the noted guidelines.
8. Before submitting your form, ensure that you have attached proof of identity and any supporting documents. Incomplete applications will be returned.
9. Finally, save your changes, and choose to download, print, or share the completed form as necessary.

Start your application for access to your medical records online today!