Agreement for a carer to have access to a patient’s personal details and/or copies of correspondence
To: [Insert Practice name]
I give permission for my Carer [Insert Carer Name] to have access to my medical records and personal details held by the Practice.
This permission relates to all / part of my record / specific condition only (delete as appropriate).
Where the permission is restricted to part of the record only, please specify below the precise limits of this permission, and any areas of the record which are excluded.
I understand that the doctor may override this authority at any time, and that this permission will remain in force until cancelled by me in writing.
I consent to my Carer receiving copies of all correspondence relating to my treatment (delete if not applicable). I confirm that this has been explained to me by my GP and that the GP has sole discretion to withhold all or any copies.
Signed _______________________________ (Patient)
Accepted by ___________________________ (Doctor)
Office Use Only:
Specific Copy Exclusions
Specific Copy Inclusions
website for residents of Peterborough with very useful information and support for carers
Contact Points for carers
Princess Royal Trust for Carers
Community Nursing Service
Falls Prevention Service
Red Cross Home Care Services
For hire a wheelchair or commode, get help at home, etc.
For help during the coronavirus pandemic call:0808 196 3651Open 10am - 6pm every day
For everything else call:0344 871 11 11
Royal Voluntary Service (RVS)and
NHS Voluntary service
Local Carer’s organisation
Elder respite care
Greenwood respite care
0333 242 8935
Local Carer Charities
Source of Carer Literature for Display
Carers may also visit the website link below to have personalised care information for the person you are caring for in one place