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Consent

New Data Protection Regulations:

DUE TO THE FORTHCOMING CHANGES IN THE DATA PROTECTION ACT (DPA) AND THE IMPLEMENTATION OF THE GENERAL DATA PROTECTION REGULATION (GDPR) IT IS OUR LEGAL RESPONSIBILITY TO OBTAIN FROM EVERY REGISTERED PATIENT, CONSENT FOR THE FOLLOWING:

To send text (SMS) messages regarding appointments.

To e-mail information to patients or other parties

To send information to other parties, such as: Insurance Companies, the Police or other Health providers (upon written request and authorisation).

If you have visited the Surgery recently, you will have seen the notices asking you to complete a consent form. If not, then please take a moment to download this form and return it to the surgery, so that we may scan it onto your records as proof of your permissions.

Please be aware that all your information is held securely and, is only accessed via security card and password.

Patient Name:………………………………………………………………………….

Date of Birth:…………………………………………………………………………..

Contact Phone Numbers:

Home…………………………………………………………………………………..

Mobile………………………………………………………………………………….

Do you agree to these consents?                                                         YES …………….

 

                                                                                                        NO ……………..

Signed:………………………………………………………………………………….

By signing this consent form, your rights under the new DPA and GDPR are not affected. You have the right to access any information we hold and the right to withdraw this consent should you feel your Privacy is compromised.



 
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