Patient Forms

Consent Form to nominate someone on your behalf

https://belmonthealthcentre.co.uk/wp-content/uploads/2020/06/Consent-form.-Nominate-somone-on-my-behalf-form-.-May-2018.-updated-on-6.7.18.docx

As per GDPR regulations, from age 13 a competent child can access their own GP services/consent to a parent/guardian to do this on their behalf. Patients aged 16 or over need to give consent for someone to act on their behalf. This consent will remain in place until the user revokes it.

 

Pre-School Booster Decline Immunisations Form 

https://belmonthealthcentre.co.uk/wp-content/uploads/2020/07/Decline-Imms-Form-Pre-school-booster.docx

 

General Decline Immunisations Form

https://belmonthealthcentre.co.uk/wp-content/uploads/2020/07/Decline-Immunisations-Form-2.docx