Subject Access Request (SAR)

 
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Applicant's Details
Patient's Details
Please included any former names
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Help Us To Help You 

Providing a NHS Number means that we can find a patient record more accurately, saving time and resources. 

How to find your NHS Number 

If known
Would there have been a former postal address we would have on record?: *
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Additional Information

Under the Data Protection Act you do not have to provide a reason for applying for access to health records.

  • However to help us save time and resources, it would be helpful if you could provide details informing us of periods and parts of the health records you require access to, along with details which you may feel are relevant
e.g. radiology results, information relating to a specific accident
Proof of Authority

Under the Data Protection Act 2018 you do not have to give a reason for applying for access to your health records. 

Patients with capacity and proxy nominees will be asked to provide two forms of identification one of which must be photographic identification. Please speak to reception if you are unable to provide this. 

Please supply photocopies (please do not send originals) of identification documents:

  • One form of personal photo ID 
  • Proof of your address 

Acceptable Photo Personal Identity Documents:

  • Current UK (Channel Islands, Isle of Man or Irish) passport or EU/other nationalities passports.
  • Passports of non-EU nationals containing UK stamps, a visa or a UK residence permit showing the immigration status of the holder in the UK*
  • Current UK (or EU/other nationalities) Photo-card Driving Licence (providing that the person checking is confident that non-UK Photo-card Driving Licences are genuine)
  • A national ID card and/or other valid documentation relating to immigration status and permission to work*.

Where the applicant is not able to provide acceptable photographic ID the following must be provided:

  • One form of non-photographic personal identification and one document confirming the address must be provided from different sources.
  • A passport sized photograph, endorsed on the back with a signature of a ‘person of standing’ who has known them for at least 3 years (e.g. magistrate, medical practitioner, officer of the armed forces, teacher, lawyer or civil servant)

Any document not listed above is not an acceptable form of identification e.g. organisational ID card.

Acceptable Non-Photo Personal Identity Documents:

  • Full UK birth certificate – issued within 6 weeks of birth
  • Current full driving license (old version); (provisional driving licenses are not acceptable)
  • Residence permit issued by Home Office to EU Nationals on inspection of own-country passport
  • Adoption certificate
  • Marriage / civil partnership certificate
  • Divorce or annulment papers
  • Police registration document
  • Certificate of employment in HM Forces
  • Current benefit book or card or original notification letter from the Department of Work and Pensions (DWP) confirming legal right to benefit
  • Most recent HM Revenues and Customs (previously Inland Revenue) tax notification
  • Current firearms certificate
  • Application Registration Card (ARC) issued to people seeking asylum in the UK (or previously issued standard acknowledgement letters, SAL1 or SAL2 forms)
  • GV3 form issued to people who want to travel in the UK without valid travel documents
  • Home Office letter IS KOS EX or KOS EX2
  • Building industry sub-contractor’s certificate issued by HM Revenues and Customs (previously Inland Revenue)

To confirm address, the following documents are acceptable:

  • Recent utility bill or a certificate from a supplier of utilities confirming the arrangement to pay for the services on pre-payment terms (note: mobile telephone bills must not be accepted as they can be sent to different addresses).
  • Utility bills in joint names are permissible;*
  • Local authority tax bill (valid for current year);*
  • Current UK photocard driving licence (if not already presented as a personal ID document);
  • Current Full UK driving licence (old version) (if not already presented as a personal ID document);
  • Bank, building society or credit union statement or passbook containing current address;
  • Most recent mortgage statement from a recognised lender;*
  • Current local council rent card or tenancy agreement;
  • Current benefit book or card or original notification letter from Department of Work and Pensions (DWP) confirming the rights to benefit;
  • Confirmation from an electoral register search that a person of that name lives at the claimed address;*
  • Court Order.*

*The date on these documents must be within the last 6 months (unless there is a good reason for it not to be e.g. clear evidence that the person was not living in the UK for 6 months or more) and the must contain the name and address of the applicant.

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Details of where medical records are to be sent

Examples of Non-NHS certificates, forms and reports:

Benefits certification for DWP (not on patient’s request) Charged at the fees set by the requesting Agency
Blue Badge Application appeal after rejection by the Council FreeApprox Fee
Benefits certification for Jobcentre Plus (not on patient’s request) Charged at the fees set by the requesting Agency
Cremation forms Charged at the fees set by the requesting Agency
Coroners forms Charged at the fees set by the requesting Agency
Firearms forms Charged at the fees set by the requesting Agency
Reports requested by the Army Charged at the fees set by the requesting Agency
Reports requested by the Police Charged at the fees set by the requesting Agency
Safeguarding reports for Social Services Charged at the fees set by the requesting Agency
Reports requested directly by the Council i.e. by Housing Department Charged at the fees set by the requesting Agency
Electronic insurance reports requested via iGPR Charged at the fees set by the requesting Agency
Form DS 1500 Charged at the fees set by the requesting Agency
Private sick note (incapacity certificate) required by patient for presentation to an employer except for those which the doctor is obliged to provide for statutory sick pay purposes £20-63Approx Fee
Any Support Letters i.e. for Uni/School/Benefits/Bank   £20Approx Fee
Electronically produced medical report via iGPPR software - extraction of the relevant medical records only and signed by a GP £40Approx Fee
Private referral letter and supporting information FreeApprox Fee
Adoption and Fostering: Form AH/AH2 (Adult Health Report/ Assessment for prospective carer) with Medical Examination £110Approx Fee
Adoption and Fostering: Form AH/AH2 (Adult Health Report/ Assessment for prospective carer) NO Medical Examination £80Approx Fee
 

Non-NHS work NOT completed by HHGP:

  • Asbestos medical examinations
  • Childminder health forms
  • Certificates medico-legal
  • Driver Licensing (DVLA / TfL ) assessments 
  • Fitness certificates (fit to fly, Fit to attend)
  • Holiday cancellation certificates (GPs may use own direction to complete if due to cancer / terminal illness related)
  • Occupational Health Forms for an Employer / University etc. 
  • School fees and holiday insurance certificates
  • Health club report to certify that a patient is fit for exercise 
  • Act as a referee for passport and citizenship applications
  • Any pro-forma reports and questionnaires for private purposes
  • Freedom from infection certificate eg. For school, travel or employment
 

Fees:

Practice follows BMA charges guidelines as set out on their website.

View our full Medical Reports Policy

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Declaration

You are requesting access to the records for

  • Name: 
  • NHS Number: 

Please return to the previous pages to make any amendments

  • If there is any doubt about the applicant’s identity or entitlement, information will not be released until further evidence is provided. You will be informed if this is the case.
  • Under the terms of the Data Protection Act, Subject Access Requests will be responded to within one calendar month after receiving all necessary information and/or fee required to process the request.
  • Under the terms of Section 7 of the Data Protection Act, Information disclosed under a Subject Access Request may have information removed; this is to ensure that the confidentiality is maintained for third parties referred to who have not consented to their information being disclosed.
  • Please note that we will contact the patient by telephone (using the information on their records) to verify the patients request and identity
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