Proxy Access for child under 11

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Cared for Patient’s Details

This form is specifically for children living at a different address to the parent/carer requesting access, or where the parent/carer is not a registered patient at this surgery

The proxy does not have to be a registered patient at the practice, but must be registered for online services on the GP system and always use their own login credentials.

On a child’s 11th birthday, the scope of the current proxy access will be restricted, unless the GP has already assessed the child as able to make an informed decision and the child has given explicit consent for their record to be shared. This is a national standard imposed by NHS England to protect the confidentiality rights of young people. We will send a letter to the child and to their parent/legal guardian on their 11th birthday to inform them of this change. 

Parent / Carer Details

(Requesting proxy access to online services for the patient named above) We need these details to be able to trace your existing online user account

(if registered at another practice)

Proxy access will be given to:

  • Book/cancel appointments
  • Request repeat medication
  • View the core medical record (medication & allergies)
  • View immunisations information

If you are registered with us, access will be added to your existing Online Services account – you will be able to switch to child/cared for person’s account via Linked Users (in drop-down menu under your name). If you are registered elsewhere, we will email you the registration document you need in order to link your account to our practice patient. Please hand this form to reception – if your request is not actioned within 1 week then please contact us

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.


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