Register for Online Services

To register for our online services you will need to complete this form.

Once you are registered you will be able to use the service to:

Order your repeat prescriptions
Make an appointment
Cancel an appointment
Access to Medical Records
Review your medications and known allergies

If you are human, leave this field blank.

Full Name: *

Phone Number: *

Address, including postcode:

I wish to have access to the following online services (tick all that apply):

Booking appointments

Requesting repeat prescriptions

Accessing my medical record

Application for Online Access to My Medical Record

I wish to access my medical record online and understand and agree with each statement (please tick):

I have read and understood the important information below

I will be responsible for the security of the information that I see or download

If I choose to share my information with anyone else, this is at my own risk

I will contact the practice as soon as possible if I suspect that my account has been access by someone without my agreement

If I see information in my record that is not about me, or is inaccurate I will log out immediately and contact the practice as soon as possible

Important Information - Please read before submitting this form

If you wish to, you can now use the internet to book appointments with a GP, request repeat prescriptions for any medications you take regularly and look at your medical record online. You can also still use the telephone or call in to the surgery for any of these services as well. It’s your choice.

It will be your responsibility to keep your login details and password safe and secure. If you know or suspect that your record has been accessed by someone that you have not agreed should see it, then you should change your password immediately.

If you can’t do this for some reason, we recommend that you contact the practice so that they can remove online access until you are able to reset your password.

If you print out any information from your record, it is also your responsibility to keep this secure. If you are at all worried about keeping printed copies safe, we recommend that you do not make copies at all.

Before you apply for online access to your record, there are some other things to consider.

Although the chances of any of these things happening are very small, you will be asked that you have read and understood the following before you are given login details.

Forgotten history
There may be something you have forgotten about in your record that you might find upsetting.

Abnormal results or bad news
If your GP has given you access to test results or letters, you may see something that you find upsetting to you. This may occur before you have spoken to your doctor or while the surgery is closed and you cannot contact them.

Choosing to share your information with someone
It’s up to you whether or not you share your information with others – perhaps family members or carers. It’s your choice, but also your responsibility to keep the information safe and secure.

Coercion
If you think you may be pressured into revealing details from your patient record to someone else against your will, it is best that you do not register for access at this time.

Misunderstood information
Your medical record is designed to be used by clinical professionals to ensure that you receive the best possible care. Some of the information within your medical record may be highly technical, written by specialists and not easily understood. If you require further clarification, please contact the surgery for a clearer explanation.

Information about someone else
If you spot something in the record that is not about you or notice any other errors, please log out of the system immediately and contact the practice as soon as possible.

More information

For more information about keeping your healthcare records safe and secure please contact the surgery on 0208 863 3333.

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Register for Online Services