Register your Child for Online Services

Online access is available to children up to the age of 11. The access will automatically stop at the age of 11. At the age of 16 patients can apply for the access themselves. Once you have completed the form for your child, please email us a copy of their birth certificate adding a reference “Online access”: e82013.bridgewatersurgeries@nhs.net.

The Patient

This is the person whose records are being accessed
Name
Date of Birth
Address

The Representative

This is the person seeking proxy access to the patient's online records, appointments, repeat prescription.
Name
Date of Birth
Address
(or write "same as above" if applies)
Which online services would you like access to? (tick all that apply)
I understand that It is my responsibility to keep my account secure by keeping my details confidential I understand that I can terminate my account at any time by contacting the surgery, or change my log in details by re-registering and that this form will be kept on my electronic records I understand that my registration will be revoked if I constantly miss or cancel appointments.