Summary Care Record Opt Out

What does it mean if I DO NOT have a Summary Care Record?

NHS healthcare staff caring for you may not be aware of your current medications, allergies you suffer from and any bad reactions to medicines you have had, in order to treat you safely in an emergency.

Your records will stay as they are now with information being shared by letter, email, fax or phone.

If you have any questions, or if you want to discuss your choices, please contact us.

SCR Opt-out Form

Section A

If you are filling this form on behalf of another person or child please ensure you fill their details in section A and your details in section B.
Full Name
Date of Birth
Current Address
(if Known)

Section B

If you are filling this form on behalf of another person or child please ensure you fill their details in section A and your details in section B.
Your Name
Print Full Name