Using the NHS App for Family members

Proxy Access allows Parents, Guardians or Carers to access someone’s medical records via online services and the NHS App.

Health and Wellbeing Coach Self-Referral form

Name(Required)

First Last

Date of Birth(Required)

NHS Number

Phone(Required)

Email(Required)

Which GP practice are you registered with?(Required)

What type of support are you interested in?(Required)

Weight Management

Diabetes Management

Physical Activity

Other

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Comments

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