Online Access To Full Medical Record

This form is used to sign people up for Full Records Access and Understanding

Please complete all 10 questions. We will then process your request and send a reply back to confirm you have access to your electronic health records. It takes between 2-4 minutes to complete. Every person needs to complete this. If you are doing this on behalf of somebody else then please remember to state your relationship with the person and that you have permission to do so on their behalf
Name
Address
1. I am doing this questionnaire for myself?
2. Can you read and understand English ?
3. Have you registered for ordering repeat prescriptions and booking appointments on-line?
4. Are you happy to use passwords to access your record?
5. After you have been to the doctor or to the hospital, you can check if the encounter has been recorded and what was discussed. Do you agree this is a good reason to have access to your records?
6. Would you like to feedback what you think of the Records Access system?
7. There maybe an instance when accessing your medical records online, you may read some information that could be shocking or upsetting. What do you do if this happens and you cannot speak to your doctor / nurse immediately? Please tick all options that apply
8. You see a new letter has arrived in your electronic health record. You open up the letter to find it is about another patient in the practice. What do you do?
9. Would it upset you if you read something somebody else has said about you with regards to your health? This does NOT mean others can see your record without your permission.
10. Do you feel you understand what Records Access means?
This field is for validation purposes and should be left unchanged.
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