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Home > Online Services Request Form

Online Services Request Form

Before you apply for online access to your record, 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

Things to consider

  • Forgotten history
    There may be something you have forgotten about in your record that you might find upsetting.
  • 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 Practice is closed and you cannot contact them.
  • Choosing to share your information with someone
    It’s up to you whether 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.
Online Services Request Form
I wish to have access to the following online services (please tick all that apply)
I wish to access my medical record online and understand and agree with each statement
I agree that I may be contacted regarding advice about my health and/or appointment reminders, via the following methods

If you require letters or information in an alternative format, for example large print or easy read or if you need help with us, because you use BSL, please let us know.


Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

Learn more about our Privacy Policy and Terms of Use. 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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Dr Rasool's Practice

Abbey Health Centre, Finchale Avenue, Billingham, TS23 2DG

  • 01642 360033
  • nencicb-tv.a81602@nhs.net
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