Medical Record Content Enquiry

Use this form to ask us about something you've seen in your medical records that you think may be wrong.

Your record will contain the clinical opinion of the doctors as well as factual information and measurements. We understand you may not agree with the doctor's opinion, but this does not make it wrong or mean that we will remove it.

First NamePlease enter your first name.

SurnamePlease enter your surname (family name).

Date of birthPlease enter your date of birth

NHS numberPlease enter your NHS number if you know it.

What is the reason for your enquiry?Please pick the option that most accurately reflects the reason for your enquiry.

Please tell us the date of the entry you are enquiring aboutThis helps us to identify the entry.

Please tell us what the entry currently says.This helps us to identify the correct information.

Please explain your concern about the entry.Give as much information as possible.

What would you like to happen?Please say what your preferred outcome is.

We will review your enquiry and let you know what we decide.

If there is incorrect information included on your record then we will remove this.

If you disagree with an opinion or entry, then we will not remove this unless it is factually incorrect. We can add your opinion or comments alongside the entry for additional context.

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to Levenshulme Medical Practice • Dunstable Street, Levenshulme, Manchester, M19 3BX.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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Medical Record Content Enquiry

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