Use this service to give permission for Horizon Healthcare to discuss your medical information with another person.
This form does not provide online access, NHS App access, or full access to your medical record.
You can use this service if you are registered at the surgery.
Before you start
We will ask you for:
- patient details
- requester details
- relationship to the patient
- confirmation of consent where appropriate
You can also phone us on Burton Road 01332 737777 or Humbleton Drive 01332 737777.