Dundonald Medical Centre

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Subject Access Request (SAR) – Request your Records

You will appreciate that health data relating to any individual is highly confidential and the Practice must ensure that it releases such data only to the person to whom it relates, or to a person authorised to act on his/her behalf. Please complete this online Request Form as fully and accurately as possible.

The General Data Protection Regulations give you the statutory right of access to any information, manual (paper) or computerised.  You may wish to authorise someone else to make your application on your behalf. If you have parental responsibilities you may make an application to see your child’s notes.

You do not have to give a reason for applying for access to your General Practice records. If you do not need access to your entire records, it would be helpful if you would inform us of the periods and parts of your health records that you require, along with details which you may feel have relevance (e.g. Clinic type, location, dates)


The Practice will deal with your request as quickly as possible. The information should be available to you within 28 days of receipt of your  completed form and consent. Under certain circumstances, this period may be extended to 3 months.


We will not make a charge for the first request for access to your medical records. We may, however, charge for subsequent requests.  You have the right to simply view your records (i.e. not receive a copy in a permanent form).

Type of request

If you request to see the original records, you will be invited to make an appointment at a mutually convenient time to view them.  

If you request a copy of your medical record, this will be ready within the specified timescale and you will be contacted to collect the copy. 


Proof of identity

Photographic ID must be presented when collecting medical records, whether a copy or the original.

Subject Access Request Form

Applicant Details

I am requesting
Please note if you are not the patient, and you have the permission of a third party to act on their behalf, then both persons must be present when completing this online form.

We will require them to complete “The Authorisation of Patient if Request made by Third Party” declaration shown below. This section will appear when the relevant consent box is ticked at the end of the online form.

If this section is not completed, we cannot process the subject access request.

Enter Email
Confirm Email
Please use format day/month/year e.g. 12/05/1979

The Medical Records of another Adult

Please include postcode
Please use format day/month/year e.g. 12/05/1979

The Medical Records of a Child

Please include postcode
Please use format day/month/year e.g. 12/05/1979

Type of Request

I wish to request

Copy of Parts of Medical Records

Please detail which parts you require

Medical Records



Tick which applies


I authorise the Practice to release Personal Data requested relating to me to the above applicant to whom I have given my consent to act on my behalf.

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the Practice, to allow the Practice team to contact you and also to update your medical records held by the Practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.