If you would like to only request part of a record, please state the date range Name of GP surgery, hospital or other healthcare provider Service/treatment received Approximate date(s) that the treatment was received Name of Doctor / Consultant / Healthcare Professional seen (if known) Please provide any further details to help clarify the information that you are requesting SECTION 5: Waiver of fees for the purpose of providing evidence to the Infected Blood Inquiry The Chief Executives of NHS England, Wales, Scotland and Northern Ireland have confirmed that all fees that would normally be charged to access and obtain copies of a deceased person’s medical records will be waived for relatives seeking to do so for the purpose of providing evidence to the Inquiry. Copies of the letters to the NHS Chief Executives and their responses can be viewed on the Inquiry’s website: . SECTION 6: Proof of identity
If you would like to only request part of a record, please state the date range Name of GP surgery, hospital or other healthcare provider Service/treatment received Approximate date(s) that the treatment was received Name of Doctor / Consultant / Healthcare Professional seen (if known) Please provide any further details to help clarify the information that you are requesting SECTION 5: Waiver of fees for the purpose of providing evidence to the Infected Blood Inquiry The Chief Executives of NHS England, Wales, Scotland and Northern Ireland have confirmed that all fees that would normally be charged to access and obtain copies of a deceased person’s medical records will be waived for relatives seeking to do so for the purpose of providing evidence to the Inquiry. Copies of the letters to the NHS Chief Executives and their responses can be viewed on the Inquiry’s website: . SECTION 6: Proof of identity
Request%20form%20for%20the%20medical%20records%20of%20a%20deceased%20family%20member%20-%20version%202%20-%2004-10-2018.docx