Personal Details

Medical Record Details

Please supply details of all locations to enable us to retrieve your medical record data.

I HEREBY AUTHORISE AND REQUEST YOU to forward copies of my full and unexpurgated medical records to SK MEDICAL PRACTICE, SK House, 7 Tapton Way, Wavertree Business Village, Liverpool, L13 1DA.

I confirm that no litigation is contemplated against you or any other member of your staff.

Please tick to consent to your data being stored in line with the guidelines set out in our privacy policy