Consent to proxy access

Use this service to provide consent for proxy access to medical records.

You can use this service if you:

• are registered at the surgery

Before you start

We’ll ask you for:

• your first and last name, date of birth, sex, postcode, email and phone number
• if applicable, the details of the person you are completing the form on behalf of
• two forms of identification (one for proof of identity and one for address)

Start now

You can also phone us on Plumstead Health Centre 020 8316 5472 or Garland Road Clinic 020 8305 7600.