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... Request a Data Subject Access Request?

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Data Subject Access Request

Required fields are marked with an asterisk (*).
*Please note - This is not a mandatory form but will assist us in dealing with your data subject access requests more efficiently.
Please provide your details below
*I would like to request a copy of my medical records, please tick the most appropriate option.

(Records will be emailed to you via the email address you have provided above)

Teldoc will require you to upload two forms of ID to allow us to proceed with your request.
  • 1 x Photo ID
  • 1 x Proof of Address
Disclaimer, please read carefully

I understand there is no fee for a data subject access request, only in exceptional circumstances.

I am aware that the records provided to me will be only from my electronic medical records, unless I state otherwise.

I am aware that this information will be provided to me within one month from Teldoc receiving this request. If there is a delay, Teldoc can extend this to two months, but I will be informed, with an explanation, why this extension is necessary.

I understand I will need to provide one form of photo ID and one form of proof of address if I am collecting paper copies of my records. This is to ensure TELDOC conforms to the Data Protection Act.
Privacy Consent

Please note this form is not to be used for the following purposes:

Medical matters, Prescription requests, Patient Access requests, Appointment requests or Complaints. Medical matters cannot be dealt with via this form. If you have a query regarding a medical matter please telephone reception to make an appointment to see the appropriate person.

Other forms available

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