Skip to main content
This website has been provided to Paragon Practice for evaluation purposes, and should not be used by Patients. ×
  • Language
    • Afrikaans
    • Albanian
    • Arabic
    • Armenian
    • Azerbaijani
    • Basque
    • Belarusian
    • Bengali
    • Bulgarian
    • Catalan
    • Chinese (Simplified)
    • Chinese (Traditional)
    • Croatian
    • Czech
    • Danish
    • Dutch
    • Esperanto
    • Estonian
    • Filipino
    • Finnish
    • French
    • Galician
    • Georgian
    • German
    • Greek
    • Gujarati
    • Haitian Creole
    • Hebrew
    • Hindi
    • Hungarian
    • Icelandic
    • Indonesian
    • Irish
    • Italian
    • Japanese
    • Kannada
    • Korean
    • Lao
    • Latin
    • Latvian
    • Lithuanian
    • Macedonian
    • Malay
    • Maltese
    • Norwegian
    • Persian
    • Polish
    • Portuguese
    • Punjabi
    • Romanian
    • Russian
    • Serbian
    • Slovak
    • Slovenian
    • Spanish
    • Swahili
    • Swedish
    • Tamil
    • Telugu
    • Thai
    • Turkish
    • Ukrainian
    • Urdu
    • Vietnamese
    • Welsh
    • Yiddish
  • 01772 123456
  • Text Size
    • Increase Text Size
    • Decrease Text Size
    • Reset Text Size
Paragon Practice Providing NHS services
Providing NHS services
Search
Show Main Menu
  • Home
  • Appointments
  • Prescriptions
  • Services
  • Surgery Information
  • Health Information And Support
  • Contact
Home > Consent

Consent

Occasionally you may want someone to be able to discuss your medical records with us. This could be a partner, relative or friend. Please consider this carefully, as if you provide consent for a named person, they will be able to discuss elements of your medical care with us. If you would like someone to be able to discuss your care with us, without us requiring additional consent, please provide their details below.

For children aged 13 and younger, we will only discuss their care with people deemed to have parental responsibility unless otherwise stated.

We reserve the right to refuse access to anyone other than the individual, the medical record pertains to if there are grounds that providing access is likely to cause serious physical or mental harm to the patient or the information you have asked for contains information that relates to a third person.

Your Details

DD/MM/YYYY
Find my NHS Number (opens in new window)

Details for the named person

DD/MM/YYYY
Find my NHS Number (opens in new window)

Does the carer hold legal power of attorney?

If yes please provide a copy of the legal documents to the surgery.

I want the person to be able to discuss


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.

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.


Local Services
Motability
Macmillan
Cancer Support

Site

  • Sitemap
  • Back To Top

About

  • Disclaimer
  • Website Privacy
  • Website Accessibility
  • Cookies
  • Content Attribution

Contact

Paragon Practice

215 Kirkham Road, Freckleton, Lancashire, PR4 1HG

  • 01772 123456
© Neighbourhood Direct Ltd  2025
GP Practice Website by Oldroyd Publishing Group

Loading...

Local Services
Motability
Macmillan
Cancer Support