Data Subject Access Request (DSAR) Form

Data Subject Access Request (DSAR) Form

Please complete the form below to request a copy of your medical record and/or test results from the practice. This form helps you request access to personal data held by the Practice under the UK GDPR and the Data Protection Act 2018.

Please do consider that processing these requests can take some time, as every page of a record needs to be checked by a GP before being released to the patient. We have 1 month to respond to your request, however, this may be extended if your request is particularly complex, we will let you know if this is the case.   

If there is something specific you are looking for, or a range of dates you need for any purpose, telling us this in advance would help. You do not have to give us the reason but sometimes that can help to find the notes you are looking for. 

Equally, if there are specific tests you need, Hospital Clinic letters, or consultation notes from the GP practice, if these can be specified, that also helps cut down on paper, admin and GP time, and cost.

Identity Verification and Declaration

Please provide one form of photo ID and one proof of address (or equivalent documentation if acting on behalf of someone else). This can be done by visiting the surgery.  Requests will not be processed until this has been received.

  • Accepted photo ID: passport, driving licence, national ID
  • Accepted address proof: utility bill, bank statement (last 3 months)

By completing this form you are confirming that the information provided is accurate and that you are entitled to request access to the personal data.













This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Page last reviewed: 13 March 2026