Register for Online Services Proxy Access

To register for online services proxy access please complete the form below and submit it with one piece of photo ID. This can be attached with the form via our website dashboard.

Register for Online Services - Proxy Access

Patient Details

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.

Proxy Access

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I, the representative for the patient, wish to have access to the following online services (tick all that apply):

The following data is available to view by default: allergies and adverse reactions, medication history.

Application for online access to my medical record

I, the representative for the patient, wish to have proxy access to the services indicated above. I understand my responsibility for safeguarding sensitive medical information and I understand and agree with each of the following statements:

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To complete your registration, please upload proof of identity, this should include photographic ID and proof of address
Maximum upload size: 104.86MB