Consent to Share Information

If you are happy to give consent to share your information with a carer or relative, we will be happy to add a note to your medical record. Please complete our Consent to Share Information form.

Consent to share information

Patient Details

Carer/Relative Details

I give permission for my relative/carer to have access to my medical records and personal details held by the Practice and for staff to discuss this with my relative/carer.
This permission relates to: *