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SCR patient preference form

Download a form to opt out of having a Summary Care Record (SCR) or opt out of additional information being included in the SCR.

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SCR patient preference form

Use this form to opt out of having an SCR or opt out of additional information being included in the SCR.

Use the open document format if you do not have MS Word on your device.

SCR patient preference form (Word format)

docx 75 KB

Last edited: 28 May 2025 2:57 pm