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Letter to Request Child Medical Records and Health Information - Word & PDF Template Form

✓ Valid in United Kingdom

Create your Letter to Request Child Medical Records and Health Information - Word & PDF Template Form for use in United Kingdom. Answer a few plain-English questions and the document fills in automatically as you go — then download it in Word and PDF, ready to sign or share.

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Letter to Request Child Medical Records and Health Information - Word & PDF Template Form
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________

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________ ________

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Dear Mr ________,

Subject access request (patient medical records)


I write in relation to the child ________, who is registered as a patient at ________. I write in order to make a subject access request in relation to their health records.


Information requested

I request a copy of full medical records held by you in respect of ________. I would prefer to receive a hard copy of the information.


Child (data subject) information

Full name

________

Date of birth

________

NHS number

________

Home address

________

Proof of identity

Please find attached:

________


Requester information

Full name

________

Date of birth

________

Address

________

Relationship to data subject (child)

Mother

Legal authority to make request on behalf of data subject

In accordance with section 2 of the Children Act 1989, I hold Parental Responsibility for ________ in view of the fact that I am their mother.

Proof of authority

Please find attached:

________

Proof of requester identity

Please find attached:

________


Consent of data subject

________ is of a very young age. In view of this, I am of the opinion that they are unable to sufficiently understand the nature of this request and that they are not mature enough to make this request on their own behalf. I therefore make this request on ________'S behalf, without their consent, in view of the fact that I hold Parental Responsibility for them.


Legal basis of request

This request is made in respect of ________'S right of access to their personal medical information. The request is made in accordance with section 45 of the Data Protection Act 2018 and Article 15 of the retained EU General Data Protection Regulation 2016/679 (UK GDPR).

Should you require any further information from me in order to process my request, please do not hesitate to contact me on the details which I have provided above.



Yours sincerely,

________

Fields you complete are inserted into the document live. This template is general guidance only — not legal advice.