E Contact MY MEDICAL RECORDS ARE WRONG?

Last Updated: 26/05/2023

PATIENT DETAILS

Patient First Name *

Patient Surname Name *

Gender (We know that the options above do not represent everyone. We have to ask this question as it’s one of the necessary pieces of information for us to match your enquiry to your medical record. This means your GP can locate your record and deal with your request faster.) *

Male

Female

Other

Patient Date of Birth *

PATIENT NHS Number *

PATIENT Telephone Number *

PATIENT Mobile Telephone NUMBER *

Postcode *

MY MEDICAL RECORDS ARE WRONG

I am not trying to book an appointment, send a comunication to my GP or ask a question about a medical condition. *

I understand and agree to the above statement

The Surgery will look into your your query within 20 working days, we may contact you via Telephone, Text or Email and I agree not to contact the surgery until after this time regarding this query. Medical records cannot usually be changed, but a note may be added explaining why they are incorrect. It is important that your records are accurate because the treatment you are given may depend on them. *

I understand and agree to the above statement

Date of possible incorrect entry *

Title possible incorrect entry *

Reason why you believe the entry is incorrect *

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E Contact MY MEDICAL RECORDS ARE WRONG?

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