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Medical Records Authority

Authority For Release Of Medical Records

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.