Care Data Opt Out Form

To opt-out of Care Data please complete and submit this form.

Care Data Opt Out Form

Care Data Opt Out Form

Please tick one or both options below: *

Section A: it is important that you complete this section accurately

*
Any responses we send will go to this email address.
If you are filling out this form on behalf of another person or child, their GP practice will check that you have the authority to do so. Please ensure you fill out their details in Section A and your details in Section B.

Section B

*