Subject Access Request Application

Bedfordshire Hospitals NHSFT

Frequently Asked Questions

Question	Answer
Do I have a right to be provided with a copy of my Health Records?	Yes, under the EU and UK Law you have this right. Your request MUST be made in writing. You can do this by completing the attached form, which once completed and returned to us will give us the information we need to deal with your request.
Do I have to explain why I want a copy of my records?	No, you do not have to, however, giving us a brief explanation of why you want them will assist us in dealing with your request.
Do I have the right to be provided with a copy of another individuals Health Record?	Only if the individual you are requesting the records about is under the age of 16 and you have legal parental responsibility for them or you have been appointed by the court to manage that individuals affairs when they are unable to e.g. power of attorney. You will need to tell us why you want the records.
Do I have the right to a copy of a deceased persons Health Record?	The Access to Health Records Act 1990 provides certain individuals with a right of access to the health record of a deceased individual. These include the executor or administrator of the deceased person’s estate/will and a person who may have a claim arising out of the individual’s death. These requests will be assessed on a case by case bases
How long will it take for me to be provided with the records I request?	Under the EU and UK Law we are required to provide you with the records within one calendar month and under the Access to Health Records Act 1990 within 21 days. Where possible we aim to provide all requested records within 21 days or sooner.
Will I have to provide any identification?	Yes. You MUST send us copies of the documents listed on Section 5 of the form. Failure to send these will result in your request NOT being processed.
How will I receive the records?	This will depend on what information you are requesting. Most of the records we hold are now held electronically, so you may be provided with a disc. Records which cannot be provided on a disc will be sent to you in paper format.
What is the Secure Access portal?	It is a secure area to view and/or download your requested information. It allows for the secure sharing of sensitive information eliminating paper waste whilst increasing control, security and delivery times.

If you have any further questions or need assistance please undefined.

Part 1 of 5Who is this request for?

Note: If you are applying to access the records of more than one person e.g. those of you and your baby or Fertility records which will include your partner’s information, you must complete 2 separate forms. This will help to prevent delays in your request being processed.

Are you completing this form to: Access your own records Access records on behalf of someone else Solicitor access

Which Hospital site does your request relate to?

Part 2 of 5Name and Address

Your name and address

Title Forename(s) Last name

Current address Post code

Email Phone

Patients name and address

Title Forename(s) Last name

Date of Birth Former/Maiden name

Hospital number (if known) NHS Number (if known)

Current address Post code

Previous address (Only required if at current address less than 6 months) Post code

Email Phone

Part 3 of 5Medical Records

Part 4 of 5Proof of Identity Documents

Please tick one of the following statements that relates to your request and upload 3 documents as detailed below.

I am requesting access to information about a person who is under the age of 13 who I have parental responsibility for.

-	Their Birth certificate or Adoption certificate or proof of custody/responsibility.
-	Your Passport or Driving license or something with your signature on.
-	A Utility bill, Financial statement or Hospital letter that has your name and address on. (if possible, please black out any financial information)

I am requesting access to information about a person for who I have Power of Attorney or a Court Order of Protection.

-	A copy of the signed Power of Attorney document
-	Your passport or driving licence or something with your signature on.
-	A utility bill or financial statement that has your name and address on (If possible, please black out any financial information).

I am requesting access to information about a deceased person for who I am Executor of their Estate or Administrator of their Will.

-	An official document or letter which lists you as the Executor of their Estate or Administrator of the Will
-	Your passport or driving licence
-	A utility bill or financial statement that has your name and address on (If possible, please black out any financial information).

If none of the above statements apply to your request please undefined to discuss how you can proceed with your application.

Your ID Documents

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2 ID Documents required.

Part 5 of 5Declaration and Submit Application

WARNING: Making a false or misleading request in order to obtain access to personal information is a criminal offence.

I declare that the information provided on this application is correct to the best of my knowledge.

By signing below you are confirming:

That the information given on this form is correct.
That the copy documents being provided are true copies of genuine originals.

Dated Signature