Summary Care Record/Opt Out Form

Your Summary Care Record will contain important information about any medicines you are taking, allergies you suffer from and any bad reactions to medicines that you have had.

Giving healthcare staff access to this information can prevent mistakes being made when caring for you in an emergency or when your GP practice is closed.

Your Summary Care Record will also include your name, address, date of birth and your unique NHS Number to help identify you correctly.

You may want to add other details about your care to your Summary Care Record. This will only happen if you ask for the information to be included. You should discuss your wishes with the healthcare staff treating you.

Click here to view a leaflet containing more information.

You can choose not to have a Summary Care Record. You need to let your GP practice know by filling in and returning an opt-out form.

Click here to download an opt-out form. Alternatively, you can fill in the online opt-out form below.

SCR OptOut

Section A

Title *
Gender
Address *
Address
Postcode
City
Country

Section B

If you are filling out this form on behalf of another person or child, their GP practice will consider this request. Please ensure you fill out their details in section A and your details in section B.