Consent to access coded information with the NHS App

Required fields are labelled

What is your name?

First name

Last name

What is your date of birth?

For example, 31 3 1980

Day

Month

Year

What is your sex?

As recorded on your medical record

Male

Female

Other

What is your postcode?

The one used to register with your GP

What is your phone number?

What is your email address?

Anyone else with access to your email account may see responses sent to you

Consent

Select box to confirm Required

I confirm that I currently have the NHS App

Select box to apply Required

I would like to apply for limited access to coded information in my medical record

Select box to confirm Required

I have read and understood the Accessing GP Records Online Patient Information