Care Home Resident Form (only required for care home residents)

Please fill this form out AS WELL AS the main registration form if you are a new Care Home Resident.


Summary Care Record:

If you do not return this form, a Summary Care Record will be created for you based on implied consent. You are free to change your decision at any time by informing your GP practice.

Last Updated: 27/05/2022

Resident Details

Next of Kin/Emergency Contact

Power of Attorney

Ethnic Origin

Vitals and Lifestyle


NHS Summary Care Record

Your Summary Care Record (SCR) is a copy of key information held in your GP record includes important information about your health.


• Medicines you are taking

• Allergies you suffer from

• Any bad reactions to medicines


You may need to be treated by health and care professionals that do not know your medical history. Essential details about your healthcare can be difficult to remember, particularly when you are unwell or have complex care needs. Having a SCR means that when you need healthcare you can be helped to recall vital information.

SCRs can help the staff involved in your care make better and safer decisions about how best to treat you.

NHS Summary Care Record with additional information


You can also choose to have additional information included in your SCR, which can enhance the care you receive. This information includes:

• Your illnesses and health problems

• Operations and vaccinations you have had in the past

• How you would like to be treated - such as where you would prefer to receive care

• What support you might need

• Who should be contacted for more information about you


What does it mean if I do not have a summary care record?


NHS healthcare staff caring for you may not be aware of your current medications, allergies you suffer from and any bad reactions to medicines you have had, in order to treat you safely in an emergency.

For more information please visit, call NHS Digital on 0300 303 5678