Voluntary authorisation for organ or tissue donation
You have a choice about organ or tissue donation after your death. To find out more about why it is important that you take the time to make your donation decision and record it, go to
organdonationscotland.org.
How we use your information
The information you have provided will be used by NHS Scotland to carry out its various functions and services including scheduling appointments, ordering tests, hospital referrals and sending correspondence.
Your information, including your name, gender, date of birth and address, will be passed to NHS National Services Scotland where it will be held on the Community Health Index (CHI). This information is used to register you with the GP Practice, transfer your medical records between GP practices in the UK, make payments to GP Practices for medical services provided, and to process and issue medical exemption certificates and entitlement cards.
NHS National Services Scotland shares information about you within NHSScotland to assist in the provision and improvement of NHS services and the health of the public. When we do this, we do it as described by NHS Scotland in the NHS Inform website under the ‘How the NHS handles your personal health information’ section.
NHS National Services Scotland shares information about you within NHSScotland to assist in the provision and improvement of NHS services and the health of the public. When we do this, we do it as described by NHS Scotland in the NHS Inform website under the
‘How the NHS handles your personal health information’ section.
Find out more about NHS Scotland in the link provided above.
Patient Declaration
I declare that the information I have given on this form is correct and complete. I understand that, if it is not, appropriate action may be taken. To enable NHS National Services Scotland to confirm my eligibility to lawfully register with a GP and for the purposes of prevention, detection, and investigation of crime, the minimum necessary information from this form could be disclosed to relevant authorities.
I understand that more comprehensive information about how NHS Scotland handles my data is available from NHS Inform.
This information can be provided in other languages and formats on request. The NHS Inform helpline provides an interpreting service.
When you submit your application the contents of this form will be processed and emailed to the surgery. This process can take a little time. So, please do not close your browser window or resubmit until processing completes and you see the success message to confirm the form has been successfully sent.