Care.data Opt-Out Form

If you would like more information about the care.data programme and/or you need some assistance with making your decision please contact the national patient data sharing helpline on 0300 456 3531.

Section A:

it is important that you complete this section accurately
Please use the format DD/MM/YYYY
Please type your full name.
Please use the format DD/MM./YYYY

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:

Please type your full name.
Please use the format DD/MM./YYYY
Sending