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)

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

CAPTCHA

Name

This field is for validation purposes and should be left unchanged.