Third party consent

Use this service if you wish for someone to be able to discuss your current condition, healthcare, treatment and medication on your behalf.

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

Upon completion of this online form we will send you the third party consent form to complete and sign. This should then be brought into the surgery or posted to us.

If at any point you change your mind, please let reception know.

Start now

You can also phone us on 01603 765550.