Summer Fields School registration form

Basic Information

Medical Records

Please help us to trace your previous medical records by providing the following information. If you are from abroad please move to the next section

Medical Records (abroad)

If you are from abroad please provide the following information:

Summary Care Record

Summary Care Record (SCR) – used nationally across England

The SCR is a national database intended to help patient care, particularly in emergencies.  It contains registration details (name, address, date of birth, NHS number etc) and a list of prescribed medication and allergies.  It is useful for an Accident & Emergency department to check for allergies or drug interactions, to improve the treatment they can provide for you.  It is also possible to ask for a more detailed SCR containing significant diagnoses, referrals, vaccinations, care plans or other details.  Your permission will be checked each time, unless there is a special factor such as being unconscious or otherwise unable to consent.  For further information see https://digital.nhs.uk/services/summary-care-records-scr

Oxfordshire Summary Care

The Oxfordshire Care Summary and the Out – Hours GP records sharing system

Your patient record is held securely and confidentially on an electronic system controlled by your GP Surgery.  Your information can be viewed if you need treatment in another NHS healthcare setting, such as an Emergency Department, Out of Hours, GP, Minor Injury Unit or College Nurse (if applicable).  The professionals treating you can give you safer care if medical information from your GP Surgery is available to them.  In all these cases, your information will be viewed only by authorised healthcare professionals directly involved in your care.  You will be asked permission before the information is accessed unless the health professional is unable to ask you and there is an important clinical reason for accessing it.

Important

It is important to complete this information as your new practice cannot make a decision for you. Without your direction, we cannot guarantee that your wishes will be met, even if you have previously made a similar choice in another practice. If the person signing below is not the patient, please also enter the signatory’s name and relationship to the patient, e.g. PARENT, GUARDIAN, ATTORNEY

Ethnicity & Language

Medical Information

Routine childhood immunisations

Usually given around 2 months

Routine childhood immunisations

Usually given around 3 months

Routine childhood immunisations

Usually given around 4 months 

Routine childhood immunisations

Usually given around 12 - 13 months 

Routine childhood immunisations

Routine childhood immunisations

Usually given around 3yrs 4 months

Non-routine vaccines

Signature

Thank you

Thank you for completing this registration form. When your form is complete please press the submit button. Your registration form will be sent to the Practice.