Medical History Report Request (Subject Access Request)

If you would like to request a report, please use this form.

Please state exactly what information you are requesting. If ENTIRE medical records are required please state. Requests will be processed within 28 days of receipt of your request.

We outsource our Medical Reports to iGPR. We use a processor, iGPR Technologies Limited (“iGPR”), to assist us with responding to report requests relating to your patient data, such as subject access requests that you submit to us (or that someone acting on your behalf submits to us) and report requests that insurers submit to us under the Access to Medical Records Act 1988 in relation to a life insurance policy that you hold or that you are applying for. iGPR manages the reporting process for us by reviewing and responding to requests in accordance with our instructions and all applicable laws, including UK data protection laws.

For enquiries please contact iGPR on 01527 570005 between 09:00 and 17:00 or complete a contact form via their website:

Subject Access Request for My Medical Record

Please include your postcode.

Subject Access Request Information

Dates of Information required: *
Please format as: Between DD/MM/YYYY and DD/MM/YYYY
Relating to the medical condition(s): *
Do you require copies of correspondence/hospital letters we hold? *
Any other comments you may wish to make?

Please note that you might be contacted by the practice for further information or clarification about the request.

By signing, you indicate that you are the individual named above or have legal responsibility. The practice cannot accept requests regarding your personal data from anyone else, including family members.

If medical information has already been given in the past 2 years the practice does not need to reissue it.

Repeat requests will be/may be chargeable.

Explicit Consent for Electronic Transfer of Data *
Please upload a copy of your photo ID (e.g. Passport, drivers licence or bus pass):
Maximum upload size: 20.97MB