Proxy Access Form

Proxy access was developed to allow someone other than the patient to access and manage parts of their GP online services account. The proxy is given their own online access account. It is often used by the parents or recognised carers of young children, and recognised carers of adults.

Before completing this form please read section 1 & 2

Section 1 - Important Information - Please read before returning this form

This form will take 10 working days for receipt to action. Once we have opened your record for you to access, your login details will be sent via email to the account you have stated on this form. If you have not supplied a secure email address then you can collect the login details from your local surgery at the Reception desk.

It will be your responsibility to keep your login details and password safe and secure. If you know or suspect that your proxy access has been accessed by someone that you have not agreed should see it, then you should change your password immediately.
If you can’t do this for some reason, we recommend that you contact the practice so that they can remove online access until you are able to reset your password. If you print out any information from the Patients proxy record, it is also your responsibility to keep this secure. If you are at all worried about keeping printed copies safe, we recommend that you do not make copies at all.

Please note: If we have any reason to believe that in giving you proxy access this may cause the patient or yourself physical/ and or mental harm the practice reserve the right to refuse proxy access. Patient records will be checked upon receipt of this form in order to verify details and carry out safeguarding checks in line with legislation. If we are unable to offer you proxy access this will be discussed with you.Within your online records, beacon medical group members of staff are named in your records. By accepting your records you are bound by GDPR and therefore should not share names of staff who are named in your records. In submitting this form you have read and understand section 1 and 2 and agree with each statement.

Section 2 - Before you apply for online proxy access, there are some other things to consider.

Although the chances of any of these things happening are very small, you will be asked that you have read and understood the following before you are given login details.

Abnormal results or bad news

If your GP has given you access to test results or letters, you may see something that you find upsetting to you. This may occur before you have spoken to your doctor or while the surgery is closed and you cannot contact them. Please be assured anything that requires urgent attention will be actioned BEFORE it has been added to your patient record as information is added after review by a clinician.

Choosing to share your information with someone

It’s up to you whether or not you share your information with others – perhaps family members or carers. It’s your choice, but also your responsibility to keep the information safe and secure.

Coercion

If you think you may be pressured into revealing details from your patient record to someone else against your will, it is best that you do not register for access at this time.

Misunderstood information

Your medical record is designed to be used by clinical professionals to ensure that you receive the best possible care. Some of the information within your medical record may be highly technical, written by specialists and not easily understood. If you require further clarification, please contact the surgery for a clearer explanation.

Information about someone else

If you spot something in the record that is not about you or notice any other errors, please log out of the system immediately and contact the practice as soon as possible.

Proxy Access Form

  • Accepted file types: jpg, pdf, png.
    Please upload a photo of your head and shoulders, holding your photo ID. Please ensure we can clearly see your ID in your photo.
  • Please allow up to 10 working days for your request to be actioned. we will contact you if we need any further information.
  • This field is for validation purposes and should be left unchanged.