Local Shared Electronic Record Opt Out

Please complete our online form

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What does it mean if you opt out of Local Shared Electronic Record Sharing?

By opting out local organisations including District Nurses/ Physio/ Hospices/ CHOC- out of hours/ Adult Social Care/ NWAS - North West Ambulance will not be able to view your record and may not be aware of your current medications, allergies you suffer from and any bad reactions to medicines you have had, in order to treat you safely.

If you have any questions, or if you want to discuss your choices, please contact us.

Patient's Details
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Applicant's Details
Declaration

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

 
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