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This form is to be completed when you require:
Copies of medical information from your medical record
A letter to be completed by the practice
PLEASE NOTE: A charge is made for letters requiring completion. This charge STARTS from £39.50.
IMPORTANT INFORMATION, PLEASE NOTE THE FOLLOWING: I understand that the GP/staff will supply all information considered to be relevant. I note the practice has one month to provide the information required but also understand this timescale may increase depending on the complexity of the requests. Requests for information to be supplied earlier are done purely at the discretion of the Park Surgery pending work pressure and may incur further charges equivalent to £10 per week for each week where the SAR has been provided earlier. However, please note:
WE CANNOT GUARANTEE ANY REQUEST FOR INFORMATION WILL BE COMPLETED BEFORE THE 30 DAY TIMESCALE.
I note that the GP/Staff will redact 'third party' information in the interests of the confidentiality of other persons. I further understand that I must bring photo I.D in order to collect this information. If I elect to send someone else to collect on my behalf, I must inform the practice of this when i am contacted and understand that this nominated person will also need to bring photo I.D. Further requests for the same information may be declined or liable to attract increased charges.
Last Updated: 06/04/2023
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