Register for Airmid or SystmOnline - Trinity Medical Centre

Register for Online Services

PLEASE NOTE

If you have previously had access to AIRMID or SystmOnline and forgot your details, please email us to request we reset your details, you do not need to submit the below form if you previously used these services.

Complete the form below to register for AIRMID or SystmOnline.

Your account details will be sent to either your mobile number or email within 30 days of submitting the form.

If you are requesting online access on behalf of another patient, please visit this page for more information. You will need to visit the surgery to request a paper form.

If we hold conflicting information on your record such as a different contact number or email, we may not be able to complete your request due to mismatching information and may contact you to further clarify.

First Name

Last Name

Date of Birth

Address

Street Address Address Line 2 City Postcode Country

Enter Email Confirm Email

Phone

Please select which of the following applies

I am 16 or above and am requesting online access to my own records

I am aged 12-15 and am requesting online access to my own records (Please note an appointment with a GP is required before access can be granted)

Type of Access Requesting

Basic Access (Appointments, Prescriptions, Online Messaging)

Full Access (Basic Access + Full Online Medical Records)

Patients have the option to share their health records and information with other services that are providing them care. You also have the option to allow services to share this information with us. All the information recorded by other health care professionals forms an important part of your record and it is useful for all healthcare professionals involved in your care to be able to see everything so that they can provide the most appropriate care. This is known as Sharing In and Sharing Out. Consent must be given at each organisation that treats you and you can change your preference at any time. More information can be found on our Policies page, Data Sharing

By Submitting you are digitally signing this form. You must tick all of the above terms of agreement before you can send this application.