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Access to Information Requests and Forms

You can make a Subject Access Request (SAR) to arrange to view or be provided with copies of your medical records, or personnel records if you are currently, or have been, employed by the health board.

You are also able to make a request for the medical records of a family member with their consent or by providing the appropriate documentation required where consent cannot be provided. 

To make a request you can use one of the forms below.

Please send the application form and identification documents to information.governance.powys@wales.nhs.uk

There is also a postal address on the form if you are not able to email in the request.

For police or coronial requests please email information.governance.powys@wales.nhs.uk with the appropriate request form.

Making a request

Provide your contact details - please provide your correspondence address, and your telephone number or email address should you need to be contacted to discuss your request further.

Provide proof of your identity – please provide proof of your identity when you make your written request, such as a copy of your passport, driving licence, or birth certificate together with relevant information which can confirm your address, for example a utility bill.

Be specific – please help us identify the exact information you need. For example, do you require information regarding your health record or your NHS staff record? Do you need copies of records from a particular service, clinician or time frame? Also, if possible, please provide any reference numbers that can be used, such as your patient number or staff number.

Provide proof of relationship – if the information is regarding another person, please provide proof of relationship and any necessary consent. You will also need to state why you require the information if the person is deceased.

If your request is purely for a copy of your health record/personal information, no fee will be charged, however, if the request is asking for a report to be written or an interpretation of information within the record then an appropriate fee may be charged. 

 

Contact Information:

information.governance.powys@wales.nhs.uk

01686 252159 / 01874 442071

 Application Form - Access to Personal Information X-Ray Only (Word, 57Kb)

Application form - Access to Personal Information X-Ray.docx

 Access to information Request Form - Living Individuals (including Children) (Word, 63Kb)

Application form - Access to Personal Information - living including…

 Access to Information Request form - Deceased Individuals (Word, 60Kb)

Application Form - Access to Personal Information - for deceased…

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