East Finchley Medical Practice
Patient Online Access
Important Information
You can now use Patient Online to book appointments, request repeat prescriptions and look at your medical record online. There is some important information to consider regarding keeping your information safe and secure.
It will be your responsibility to keep your login details and password safe and secure.  If you know or suspect that your record has been accessed by someone that you have not agreed should see it, then you should change your password immediately.
If you print out any information from your record, it is also your responsibility to keep this secure.  If you are at all worried about keeping printed copies safe, we recommend that you do not make copies at all.
To register for Patient Online Access you MUST provide us with 2 proofs of ID - 1 MUST contain a photo & 1 MUST be a Proof of address eg. Utility bill – we will need to take copies of these.
If you wish to have Detailed Coded Records Access (DCRA) you will need to specify this on the application form and your application will take 14 working days to process.
For access to book appointments and request repeat prescriptions please complete the form below and bring it into the practice with your identification. Our reception team will normally be able to process your application fairly quickly and provide you with your log in details straight away. However, at particularly busy times, you may be asked to wait or for the details to be sent to you at a later date.

Before you apply for online access to your record, there are some other things to consider:
Although the chances of any of these things happening are very small, you will be asked that you have read and understood the following before you are given login details.
Forgotten history 
There may be something you have forgotten about in your record that you might find upsetting. 	
Abnormal results or bad news  
If your GP has given you access to test results or letters, you may see something that you find upsetting to you. This may occur before you have spoken to your doctor or while the surgery is closed and you cannot contact them. 	
Choosing to share your information with someone 
It’s up to you whether or not you share your information with others – perhaps family members or carers. It’s your choice, but also your responsibility to keep the information safe and secure.  	
Coercion 
If you think you may be pressured into revealing details from your patient record to someone else against your will, it is best that you do not register for access at this time.	
Misunderstood information 
Your medical record is designed to be used by clinical professionals to ensure that you receive the best possible care.  Some of the information within your medical record may be highly technical, written by specialists and not easily understood. If you require further clarification, please contact the surgery for a clearer explanation. 	
Information about someone else 
If you spot something in the record that is not about you or notice any other errors, please log out of the system immediately and contact the practice as soon as possible.	

Application for online access to my medical record

Section 1:
Surname	Date of birth	
First name	
Address

Postcode	
Email address	
Telephone number	Mobile number	
Section 2:   I wish to have access to the following online services (please tick all that apply):
1.  Booking appointments		
2.  Requesting repeat prescriptions		
		
3. Detailed Record Coded Access (Application will take 14 working days)		

Section 3:   I wish to access my medical record online and understand and agree with each statement (tick)
1.  I have read and understood the information leaflet provided by the practice		
2.  I will be responsible for the security of the information that I see or download		
3.  If I choose to share my information with anyone else, this is at my own risk		
4.  If I suspect that my account has been accessed by someone without my agreement, I will contact the practice as soon as possible	
	
5.  If I see information in my record that is not about me or is inaccurate, I will contact the practice as soon as possible	
	
6.  If I think that I may come under pressure to give access to someone else unwillingly I will contact the practice as soon as possible. 

Section 4:		
Signature:

	Date:	

Section 5: For practice use only
NHS number:	EMIS Number:	
Identity verified by (initials)	Date	Method
Vouching   □
Vouching with information in record   □ 
Photo ID and proof of residence (copies taken)   □	
Section 6: For staff use only	
Authorised by:	
Date:	
Date account created: 	
Registration information given in person on: 	
OR	
Registration information sent on:	
Level of record access enabled:
Core				□ 
Partial				□
Detailed coded record 	□
Disabled (no access) 		□	Notes / explanation