Documents and Forms

Documents and Forms

Documents and Forms

All documents are in Adobe Acrobat format (.pdf) and can be viewed on any computer or smart phone.

New Patient Documents

To register as a new patient at My Health you will need to complete a New Patient Questionnaire for each patient wishing to register and hand these to one of our reception teams to be processed. Please bring ID with you when dropping in your completed forms. We cannot see you until this process has been undertaken:

PDF My Health New Patient Questionnaire August 2019

 Change of Patient Details Form

PDF Access to Online Services for Housebound Patients Form


Electronic Prescriptions

PDF Patient Nomination Form

PDF Patient Cancellation Form


Health Care Leaflets

PDF Contraceptive Implant

PDF Contraceptive IUD

PDF Books On Prescription

PDF Who Should I See at MyHealth?

PDF York Integrated Care Team Directory of Service

Medical Record Data Sharing

PDF Who Has Access To My Health Care Data?

PDF Summary Care Record Information

PDF Summary Care Record Opt-Out Form

PDF HSCIC Data Sharing




PDF How To Make A Compliment or Complaint

PDF Privacy Policy March 2020

PDF Access to Medical Records Patient Information

PDFAccess to Medical Records E-Access Request Form

PDF Patient Privacy Information Leaflet

PDF Children’s Privacy Information Leaflet

PDF MyHealth CQC Statement of Purpose 2018

 Change of Patient Details Form

MyHealth Fees List July 2018 

 2 Minute Patient Survey


MyHealth Matters – July 2019

MyHealth Matters – Spring 2018

MyHealth Matters – Winter 2017

PDFMyHealth Matters – Winter 2016

PDF MyHealthMatters – Summer 2014

PDF MyHealthMatters – Spring 2014

PDF MyHealthMatters – Summer 2013

PDF MyHealthMatters – Spring 2013

PDF MyHealthMatters – Winter 2012

PDF MyHealthMatters – Issue 1

PDF MyHealth Practice Brochure – July 2019


Survey Reports

PDF Patient Participation Enhanced Service Report 2014/15

PDF Annual Patient Survey Report 2014

PDF Patient Participation Report 2012-2013

PDF Annual Patient Survey Report 2012

PDF Patient Reference Group Survey Report June 2012