Register for online services

If you wish to, you can now use the internet to book appointments with a GP, request repeat prescriptions for any medications you take regularly and look at your medical record online. You can continue to use the telephone or call in to the surgery for any of these services as well. It’s your choice.

Being able to see your record online might help you to manage your medical conditions. It also means that you can even access it from anywhere in the world should you require medical treatment on holiday, business or family trips. If you decide not to join or wish to withdraw, this is your choice and practice staff will continue to treat you in the same way as before. This decision will not affect the quality of your care.

Please ensure that you read the leaflet about Online Records Access (on the main registration page) first.

Please select the practice location most relevant to this Online Form submission:

Title

First names

Surname

Date of birth

Home address

Postcode

Telephone number

I wish to have access to the following:- (select all that apply)

Booking appointments

Requesting repeat prescriptions

Accessing the medical record

Application for online access to the medical record

I wish to access the medical record online and understand and agree with each statement

I have read and understood the information leaflet provided by the practice

I will be responsible for the security of the information that I see or download

If I choose to share my information with anyone else, this is at my own risk and the practice will not be held responsible

I will contact the practice as soon as possible if I suspect that my medical record has been accessed by someone without my agreement

If I see information in my record that it not about me, or is inaccurate I will log out immediately and contact the practice as soon as possible

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to The Farley Road Medical Practice • Farley Road, 53 Farley Road, South Croydon, Surrey, CR2 7NG.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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