Information from your own record or the record of a dependant or family member can be requested from the Clinical Record Service by sending your request in writing OR completing the Release of Information form [PDF, 421 KB], and sending this information to the Release of Information Team by email or mail.
Request in writing
If you are sending your request in writing rather than completing the Release of Information form, please ensure you provide the following information so your request can be actioned without delay:
Patient first name and surname
Patient Date of Birth
Patient NHI number (if possible)
Specific details of the information you require including dates of hospital admissions
Date the record is required by and the reason if urgent
Your name (if not the patient)
Your contact number and mailing address
Proof of identity (drivers licence or passport)
If the request is for the clinical record of a family member who is not a dependant (16 years or under) then that person's consent is required in writing.