E Contact Register for NHS Online access to your medical records

Last Updated: 26/05/2023

ABOUT YOU

To register for our online services you will need to complete this form and your record will be updated within 10 working days.

You may be sent a text or email with a link to your linkage key letter.

First Name *

Surname *

DOB *

Mobile Telephone Number *

Email Address *

Address 1 *

Address 2 *

Town *

Post Code *

ONLINE SERVICES

WHICH ONLINE SERVICES WOULD YOU LIKE ACCESS TO? (TICK ALL THAT APPLY) *

Order Repeat Prescriptions

Make an Appointment

Cancel an Appointment

Change personal details

Review your medications and known allergies

View Medical Records

Results

I understand that It is my responsibility to keep my account secure by keeping my details confidential I understand that I can terminate my account at any time by contacting the surgery, or change my log in details by re-registering and that this form will be kept on my electronic records I understand that my registration will be revoked if I constantly miss or cancel appointments. *

I consent to the practice collecting and storing my data from this form

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E Contact Register for NHS Online access to your medical records

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