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Access to Summary Records Application Form

If you wish to, you can now use the internet to book appointments with a GP, request repeat prescriptions for any medications you take regularly and look at your medical record online. You can also still use the telephone or call in to the surgery for any of these services as well. It’s your choice.

Please read this leaflet for more information about accessing your summary record

Access your Summary Record Online >>

To register you will need to complete the application form below.  Once this form has been submitted you will need to provide proof of identity by taking this to the surgery you are registered at (Lofthouse Surgery or The Manse Surgery).  You will need to do this before access to online services can be granted.

 

1Access to Summary Records Application Form

I wish to access my medical record online and understand and agree with each statement

Although sending information across the Internet means that privacy of data cannot be absolutely guaranteed, our online forms offer high levels of security. The forms use HTTPS and TLS (using a 2048 bit certificate) to encrypt data sent to and from your computer when using the site and our server environment is PCI DSS certified - the highest standard of security associated with e-commerce and online finance solutions.

Form submissions are stored on the server for 28 days and are encrypted and secured with a private key known only by the GP Practice.

Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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Lofthouse Surgery - 2 Church Farm Close, Lofthouse, Wakefield, WF3 3SA
The Manse Surgery - 4 Marsh Street, Rothwell, Leeds, LS26 0AE
Practice Website supplied by Oldroyd Publishing Group
Your Neighbourhood Professionals Queen Elizabeth Grammar School Thomas Therapy Thorpe Pharmacy
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