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    *APPLICATION TYPE

    New ApplicationRenewal Application

     

    PERSONAL DETAILS

     

    GENERAL PRACTICE DETAILS

     

    MEDICAL CONDITIONS

    *Have you declared any medical conditions on your application form? (Please tick)

    YesNo

     

    FIREARMS MEDICAL REPORT CONSENT FORM

    We need your consent by ticking the box below to complete this review.
    We will need a copy of your medical records and your formal permission to hold and review your records.

     

    What we need

    We will need a full copy of your medical records. You are entitled to a copy of your records, without charge, under the General Data Protection Regulations. Your GP practice is required to respond to your request and provide you with a copy of your records within 30 days. Your GP might offer you several alternatives.
    The copy we need must include all of your records including any letters and copies of any old records cards that may still exist but may be paper or electronic.
    These records if in electronic form, sent to email address: info@shotgunmedicals.com or can either be posted to Shotgunmedicals at 4 Victoria Mount, Oxton, Wirral, CH43 5TH.

     

    UPLOAD YOUR MEDICAL RECORDS (optional)

    I would like to send my records via post or email, not as an upload

     

    TERMS & CONDITIONS (Please tick to confirm)

    *By checking this box, I confirm that I have read and understood the Firearms Medical Report Consent Form detail above.

    *By checking this box, I confirm that I have read and understood the terms and conditions outlined on this website.

    *By checking this box, I confirm that I give Shotgun Medicals permission to access, obtain and review my medical records for the sole purpose of acquiring a Shotgun or Firearms Medical Certificate.

     

    ACCEPTANCE & SIGNATURE

    *Please accept the ticking of this box as my e-signature

    NB: By e-signing this form you are consenting to the processes and actions outlined above.

     

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