Register for Online Access - Proxy User

Use this form to apply for proxy access to another persons account. This could be an elderly relative or a child for example. Once the form is received a consent form will be sent to be signed by anyone over 11 years old. The proxy account will be linked to your own account meaning you will only need to use one log in.

Last Updated: 19/07/2021

Patient Details

Please complete this section with the details of the account you would like to access. Once this form is received we will send a consent form to be signed by any patient over 11 years old.

User Details

Please complete this section with your own details.