We will acknowledge receipt of your request within one working week of receipt. If you have not received an acknowledgement within 3 working weeks please contact the Data Protection Officer, Health Records Department on the address above or by telephoning: 01387 246246. DPA Check list Internal Use Only Received by Acknowledgement letter sent on (Inits only) Date form received 201__/____________ Our Ref: _____/________/201____ Are additional identity checks Identity checks completed on: Identity checks by (Inits only) required: _____/________/201____ Yes No Is clarification of requirement Clarification letter sent on Clarification letter by: Reply received on: (Inits only) needed? _____/________/201____ _____/________/201____ Yes No Fees assessed at: Fees and invite letter sent on: Fees and invite letter by:(Inits Fees received only) _____/________/201____ £____:____
We will acknowledge receipt of your request within one working week of receipt. If you have not received an acknowledgement within 3 working weeks please contact the Data Protection Officer, Health Records Department on the address above or by telephoning: 01387 246246. DPA Check list Internal Use Only Our Ref: 201__/____________ Date form received Received by (Inits only) Acknowledgement letter sent on _____/________/201____ Are additional identity checks required: Yes No Identity checks completed on: _____/________/201____ Identity checks by (Inits only) Is clarification of requirement needed? Yes No Clarification letter sent on _____/________/201____ Clarification letter by: (Inits only) Reply received on: _____/________/201____ Fees assessed at: £____:____ Fees and invite letter sent on: _____/________/201____ Fees and invite letter by:(Inits only) Fees received
DPA_Subject_Access_Request_to_Personal_Health_Records.docx