Dissent from Secondary Use of GP Patient Identifiable Data Form

This is the opt out form for type 1 data sharing

Last Updated: 11/06/2021


Dear GP, I am writing to give notice that I refuse consent for my identifiable information to be transferred from you practice systems for any purpose other than my medical care. Please take whatever steps necessary to ensure my confidential personal information is not uploaded and record my dissent by whatever means possible. This includes adding the "Dissent from Secondary Use of GP Patient Identifiable Data" code (Snomed CT: 827241000000103 to my records. I am aware of the implications of this request, understand it will not affect the care that I receive, and I will notify you should I change my mind.



I confirm all the above is correct on sending this form.
This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.