Register for Online Services

I wish to have access to the following online services (please select all that apply):
I wish to access my medical record online and understand and agree with each statement:

Terms and Conditions

I understand that it is my responsibility to keep my account secure by keeping my details confidential I understand that I can terminate my account at any time by contacting the surgery, or change my log in details by re-registering and that this form will be kept on my electronic records I understand that my registration will be revoked if I constantly miss or cancel appointments.
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