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GRAVESEND MEDICAL CENTRE

1 New Swan Yard, Gravesend, KENT, DA12 2EN

Dr Soile, Dr Sharma, Dr Cann, Dr Kotwal, Dr Abimbola
Tel: 01474 534 123  

 

* TELEPHONE CONSULTATIONS ARE NOW BOOKABLE ONLINE

* VIDEO CONSULTATIONS AVAILABLE - PLEASE SPEAK TO A RECEPTIONIST FOR DETAILS


We remain closed until further guidance from the government is received however we are currently planning how we will keep patients and staff safe when the doors reopen - updates will follow

 

 

 

Message from the GP Partners 

In order to keep our patients and our staff safe the surgery is now closed to 'walk-ins' until further notice. 

Face-to-Face appointments will now ONLY be offered after a triage call with a GP 

 


Please visit our CORONAVIRUS UPDATES page for further details

 

 

SUBJECT ACCESS REQUEST (SARS) APPLICATION FOR ACCESS TO MEDICAL RECORDS

General Data Protection Regulation 2018 (Formally Data Protection Act 1998)

 

Details of the Record to be Accessed:

Patient Surname

NHS Number

 

Forename(s)

 

Address

 

 

 

 

 

Date of Birth

 

TELEPHONE NUMBER:

 

 

 

Details of the Person who wishes to access the records, if different to above:

Surname

 

Forename(s)

 

Address

 

 

 

 

Telephone Number

 

Relationship to Patient

 

 

Declaration: I declare that the information given by me is correct to the best of my knowledge and that I am entitled to apply for access to the health records referred to above under the terms of the General Data Protection Regulation 2018.

 

Tick whichever of the following statements apply. 

  • I am the patient.
  • I have been asked to act by the patient and attach the patient’s written authorisation. 
  • I am acting in Loco Parentis and the patient is under age sixteen, and is incapable of understanding the request / has consented to me making this request.

            (*delete as appropriate).

 

  • I am the deceased patient’s Personal Representative and attach confirmation of my appointment.
  • I have a claim arising from the patient’s death and wish to access information relevant to my claim on the grounds that (please supply your reasons below).

 

Applicant signature..................………..Date………………………..

 

 

 

 

Details of Application                        (please tick as appropriate)

 

Patient to complete

 

I am applying for access to view my records only

 

I am applying for copies of my medical record

 

I have instructed someone else to apply on my behalf

 

 

Notes:

 

Under the General Data Protection Regulation 2018 you do not have to give a reason for applying for access to your health records however:

 

“1, Recital 63, “Where the Gravesend Medical Centre processes a large quantity of information concerning the patient, the Surgery should be able to request that, before the information is delivered, the patient specify the information or processing activities to which the request relates.”

 

You will be asked to provide 2 forms of identification 1 of which must be photographic i.e. driving licence.

 

SARs are free in the first instance unless they are deemed “unfounded” or “excessive”;

 

2, GDPR Article 15(3) “Gravesend Medical Centre shall provide a copy of the personal data free of charge however if further copies are requested, the surgery may charge a reasonable fee based on administrative costs.”

 

Optional - Please use this space below to inform us of certain periods and parts of your health record you may require, or provide more information as requested above.

 

This may include specific dates, consultant name and location, and parts of the records you require e.g. written diagnosis and reports.

 

I would like a copy of all records

 

 

I would like a copy of records between specific dates only (please give date range) below

 

 

I would like copy records relating to a specific condition / specific incident only (please detail below)

 

 

 

 


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