Lincoln House Surgery

Lincoln House Surgery

163 London Road, Apsley, Hemel Hempstead, HP3 9SQ

Current time is 04:42 - Sorry, we're currently closed. Please call NHS 111

NHS

Telephone: 01442 254 366

When the practice is closed please dial 111 For emergencies dial 999

Breaking News: FLU CLINICS update: Limited appointments left for Saturday 25th September. More appointments added mid-week but they are filling fast. Book ASAP to avoid disappointment.  Click on the LINCOLN HOUSE SURGERY 2021 section on the blue banner (or menu if you are on a mobile device) for more information. 

Access to Detailed Coded Medical Records

Patient Request and Consent form

If you would like to have a secure online access to your records, we need to make sure that you understand what this involves and that you are happy for us to use the information about you (provided below) to set up and operate the service.

The following form will take you through the things you need to think about. By signing the form you will be giving us your permission to go ahead with setting up the service for you. If you decide not to join, or wish to withdraw, it will not affect your treatment in any way.

Detailed Coded Record Access - Request and Consent Form

Declaration (Please note that you will have to AGREE TO ALL. If you do not, access will not be granted)(Required)
Other considerations - Declaration (Please note that you will have to AGREE TO ALL. If you do not, access will not be granted)(Required)

Patient Details

Name(Required)
Date of Birth(Required)
YESNO - If NO , please also fill a Patient Online Access Form
Consent(Required)
This field is for validation purposes and should be left unchanged.