Summary care record choice form

Use this service to tell us your preference about your summary care record.

Your summary care record includes details of any medicines you are taking, any allergies you suffer from and any bad reactions to medicines that you have had.

It also includes your name, address, date of birth and your unique NHS number to help identify you correctly. Additional information can also be added to your summary care record.

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

Start now

You can also phone us on 01362 852 800.