Request access to a My Health Online account

Request for a My Health Online Account

SMS Text Messaging is a service offered across Wales where all GP Practices have the ability to send text reminders for appointments and information about services to patients. Are you happy to be contacted via SMS Text Messaging? *

Yes

Patient Details

First Name: *

Surname: *

Home Phone Number:

Mobile Phone Number:

Email Address: *

Address (including postcode): *

Preferred language: *

Welsh

English

Please create a My Health Online Account and issue me with a letter containing my account details.

Signature: *

Date:

Please attach identification, preferably photo ID (e.g. driving licence or passport)

Maximum upload size: 67.11MB

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Request access to a My Health Online account

Patient Details