Request form for copy of Test Results and Letters

You may wish to have a copy of your test results or hospital letters for your own records.

Please use this form to request these, and a Reception staff member will contact you when they are ready to collect.

Your Details

Name *

Date of Birth *

Phone Number

Email Address *

Request for copy of Test Results or Hospital Letters

Test or Letter Date (if known)

What test result or hospital letter do you require? *

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data. *

I consent to the practice collecting and storing my data from this form.

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Page last reviewed: 24 September 2025
Page created: 19 September 2025

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Request form for copy of Test Results and Letters

Request form for copy of Test Results and Letters

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