Skip to main content

Medical report request

Medical Report Request

What type of medical report do you require?
Are you requesting this report for a child?
Is the child aged 12 or over?

As your child is over 12 years old, they are required to provide written permission for us to share information from their medical record with you.

Please attach signed permission from your child with this form. This written permission should be specific to this particular request and what is being asked for and will be stored on their record.

Maximum upload size: 67.11MB