Patient Information

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We take patients from a wide geographical area around Wotton-under-Edge. Please refer to our Maps page.

New patients are required to complete form GMS1, which can be brought in or sent to the surgery.

You can download a copy of the form below, as well as an Organ Donor Registration form.

Download 1: GMS1 Form

Download 2: Organ Registration

Download 3: New Patient Questionnaire


Patient Information

Download 3: Practice Charter 

These files are in .PDF format, you will need   to view them, which is free to download.



Patient Confidentiality and the Data Protection Act

All information held at the Practice about patients is confidential, whether held electronically or in hard copy

Staff must not under any circumstances disclose patient information to anyone outside the Practice, except to other health professionals on a need to know basis, or where the patient has provided written consent.

All patients can expect that their personal information will not be disclosed without their permission (except in the most exceptional circumstances when disclosure is required when somebody is at grave risk of serious harm).

We need to hold personal information about you on our computer system and in our paper records to help us to look after your health needs, and your doctor is responsible for their accuracy and safe-keeping. Please help to keep your record up to date by informing us of any changes to your circumstances.

Doctors and staff in the practice have access to your medical records to enable them to do their jobs. From time to time information may be shared with others involved in your care if it is necessary. Anyone with access to your record is properly trained in confidentiality issues and is governed by both a legal and contractual duty to keep your details private.

All information about you is held securely and appropriate safeguards are in place to prevent accidental loss. 

In some circumstances we may be required by law to release your details to statutory or other official bodies, for example if a court order is presented, or in the case of public health issues. In other circumstances you may be required to give written consent before information is released – such as for medical reports for insurance, solicitors etc.

To ensure your privacy, we will not disclose information over the telephone or fax unless we are sure that we are talking to you. Information will not be disclosed to family, friends, or spouses unless we have prior written consent, and we do not leave messages with others. 

You have a right to see your records if you wish. Please ask at reception if you would like further details. An appointment will be required. In some circumstances a fee may be payable.

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