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Inchcruin Medical Practice > Forms > Test Results Request Form

Test Results Request Form

Please complete this form to request your test results. A member of the Practice Team will call you within 2 working days.

Test Results Request

First Name *

Last Name *

Email *

Date of birth *

Please use format day/month/year e.g. 12/05/1979

Phone Number *

Type of test

Date test taken

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

I consent to the practice collecting and storing my data from this form.

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Test Results Request Form

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