Self-help guide
Sample letter wording
I, [insert name of patient] of [insert address of patient] born on [insert date of birth of patient], authorise [name of person to whom you are giving authority] to access my medical records.
[Name of person to whom you are giving authority] is my [state relationship, e.g. parent/spouse/other person] and they live at [insert address of person to whom you are giving authority].
I also authorise [name of person to whom you are giving authority] to correspond, request, receive copies of any documents relevant to my case, and to communicate with you on my behalf. This authority is effective immediately.
Signed [insert name of patient]
[insert date of letter]
Sample letter example
I, Bob George of 123 Fake Street, London born on 4th July 1983, authorise David Frank to access my medical records.
David Frank is my brother and they live at 456 New Road, London.
I also authorise David Frank to correspond, request, receive copies of any documents relevant to my case, and to communicate with you on my behalf. This authority is effective immediately.
Signed Bob George
20th July 2026