About our Summary Care Record Form

Help us to help you – please fill in this important form - it is called a summary care record.

To help us to help you, we need to understand more about you and your health.  To Summary Care Record Formdo this we ask our patients to tell us about themselves. You can do this on our new form.  We call it a Summary Care Record Form.

Your Doctor will use this to update your Summary Care Record.  The Record has information about your health, the medications which you take and any which might make you ill (allergic reaction).  A Doctor or Nurse who doesn't know you very well, might ask to look at your Summary Care Record.  The Record gives them the right information to care for you.

You can watch our 2 minute video which tells you more about this form, why it is important and how it will help you.

Click on the image below to view the video:

About the Summary Care Record Form

You can look at this form in a book format by following this link:>>


Only people like a Doctor or Nurse who are treating you can see your Summary Care Record. The Doctor can add extra information to your record with things like a history of your health problems, operations, or an illness you have had. It can include information about who supports you and what help or type of information you might need at appointments.

The extra information can help Doctors and Nurses, no matter where you are treated, look after you and help keep you well.

If you would like extra information about your health and what support you need to be added to your Summary Care Record, let your Doctor know.

If you do not want your information on your Summary Care Record you can ask your doctor to remove it.

Click on the image below to see the form:

Summary Care Record Form

You can print off the form and fill it in with a pen or you can type you answers onto the form and save the form and then print the form off.  When you have filled in your form you can bring it to the surgery when you come and see us or give to one of our team on the front desk. Do not email it

Please follow these steps to complete the form:

  1. Download the form by following this link:>>Summary Care Record Form;
  2. Complete this form either by printing it off and filling the form in with a pen or you can fill the form in on your computer and then print off your completed form;
  3. Once your form is complete and you have filled in all the information and you have printed it off please give it to us at the surgery;
  4. You can either bring it with you to your next appointment or hand it to one of our Receptionists;
  5. Your completed Summary Care Record Form will have very personal information on it so please keep it safe – do not email it. Just bring it straight to us at the surgery and we will do the rest.

This form is very important and will help us to give you the right support. If you have any questions, please tell us at the surgery and we will try and help.

Thank you!

The Doctors and Nurses at The Cranborne Practice. 

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