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PLEASE ONLY COMPLETE THIS FORM IF YOU ARE REQUESTING A NEW MY CARE ACCOUNT FOR YOURSELF AND YOU HOLD A MEDICAL RECORD WITH ROYAL DEVON.

• If you are aged 12- 15 and would like a MY CARE the Patient Portal account – please request this at your next appointment with a Clinician.
• Parents/Guardians who would like proxy access to their child’s (under 16) MY CARE the Patient Portal account – please request this at their next appointment with a Clinician

PLEASE ONLY COMPLETE THIS FORM IF YOU ARE REQUESTING A NEW MY CARE ACCOUNT FOR YOURSELF AND YOU HOLD A MEDICAL RECORD WITH ROYAL DEVON.

Parents/Guardians who would like proxy access to their child’s (under 16) MY CARE the Patient Portal account – please request this at their next appointment with a Clinician.

For patients 16 years and over;

In order to access your MY CARE the Patient Portal account, please complete the form below. Once submitted, we will match your details with those in your medical record, if it is a complete match we will approve your form. If the match is incomplete a member of the MY CARE Helpdesk will contact you to process and verify your request – this can take up to 5 working days.
Once approved, you will receive an email/text message with your activation code and instructions on how to activate your MY CARE the Patient Portal account. If you have any questions please contact the MY CARE Helpdesk on 01392 404664.

If you are unsure of your NHS number this can be found by contacting your GP, on a recent hospital letter or by clicking here: Find your NHS number - NHS (www.nhs.uk)

PLEASE ONLY COMPLETE THIS FORM IF YOU ARE REQUESTING A NEW MY CARE ACCOUNT FOR YOURSELF AND YOU HOLD A MEDICAL RECORD WITH ROYAL DEVON.

Name (Please enter your legal name as it appears on your medical record)

Address (Please enter the address we hold on your medical record)

• If you are aged 12- 15 and would like a MY CARE the Patient Portal account – please request this at your next appointment with a Clinician.
• Parents/Guardians who would like proxy access to their child’s (under 16) MY CARE the Patient Portal account – please request this at their next appointment with a Clinician

PLEASE ONLY COMPLETE THIS FORM IF YOU ARE REQUESTING A NEW MY CARE ACCOUNT FOR YOURSELF AND YOU HOLD A MEDICAL RECORD WITH ROYAL DEVON.

Name (Please enter your legal name as it appears on your medical record)

Address (Please enter the address we hold on your medical record)

• If you are aged 12- 15 and would like a MY CARE the Patient Portal account – please request this at your next appointment with a Clinician.
• Parents/Guardians who would like proxy access to their child’s (under 16) MY CARE the Patient Portal account – please request this at their next appointment with a Clinician

PLEASE ONLY COMPLETE THIS FORM IF YOU ARE REQUESTING A NEW MY CARE ACCOUNT FOR YOURSELF AND YOU HOLD A MEDICAL RECORD WITH ROYAL DEVON.

Name (Please enter your legal name as it appears on your medical record)

Address (Please enter the address we hold on your medical record)

• If you are aged 12- 15 and would like a MY CARE the Patient Portal account – please request this at your next appointment with a Clinician.
• Parents/Guardians who would like proxy access to their child’s (under 16) MY CARE the Patient Portal account – please request this at their next appointment with a Clinician

PLEASE ONLY COMPLETE THIS FORM IF YOU ARE REQUESTING A NEW MY CARE ACCOUNT FOR YOURSELF AND YOU HOLD A MEDICAL RECORD WITH ROYAL DEVON.

Name (Please enter your legal name as it appears on your medical record)

Address (Please enter the address we hold on your medical record)

• If you are aged 12- 15 and would like a MY CARE the Patient Portal account – please request this at your next appointment with a Clinician.
• Parents/Guardians who would like proxy access to their child’s (under 16) MY CARE the Patient Portal account – please request this at their next appointment with a Clinician

PLEASE ONLY COMPLETE THIS FORM IF YOU ARE REQUESTING A NEW MY CARE ACCOUNT FOR YOURSELF AND YOU HOLD A MEDICAL RECORD WITH ROYAL DEVON.

Name (Please enter your legal name as it appears on your medical record)

Address (Please enter the address we hold on your medical record)

• If you are aged 12- 15 and would like a MY CARE the Patient Portal account – please request this at your next appointment with a Clinician.
• Parents/Guardians who would like proxy access to their child’s (under 16) MY CARE the Patient Portal account – please request this at their next appointment with a Clinician