DSAR FORM
NOTE: This is not a mandatory form. Data subject access requests will be accepted in other formats; however, using this form will assist us in locating and proving your personal data quickly and efficiently. |
Taiglum Medical Practice is a “data controller” for the purposes of relevant data protection legislation. You have the right to access personal data held about you by the Company. You should use this form to tell us what personal data you wish to access. Please note that we may require proof of identity before processing your request.
If we consider that your request is manifestly unfounded or excessive, we may require you to pay a fee in order to respond to the DSAR, or we may refuse to comply. In all other cases, there is no fee to make a DSAR.
Please note that we may be unable to provide certain information where the rights of third parties are impacted. If that is the case we may restrict the data released or redact documents to remove third party data. We may also be unable to release data if one of the exemptions in the relevant legislation applies.
We will endeavour to respond to your request within one month. However, depending on the extent of your request and the volume of data we require to locate, we may extend this deadline to three months from the date of request.
If you are dissatisfied with our response to your DSAR, please write to Mrs Sandra Barret, practice manager giving your reasons. You are also entitled to make a complaint to the Office of the Information Commissioner. Further details can be found at https://ico.org.uk/concerns/.
Applicant details
Please state your full name and indicate which name, combination of names, variant spellings of your name or nicknames you wish us to search for when locating personal data. | |
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Subject matter of request
Please use this section to indicate whether the personal data you are requesting relates to a particular subject matter, for example, a particular decision or incident.
Location of data
Please use this section to indicate any particular locations in which you would like us to search for your personal data. This could be, for example, your personnel file or particular email accounts.
Time frame of search
Given the resources required to conduct a search (particularly of email accounts) please indicate if there is a relevant time frame which we can use to narrow our search.
Declaration
I have read and understood this form and the information I have supplied is correct.
INTERNAL USE ONLY |
If identity documents are required, please indicate which document was checked: |
| Photo driving licence | | Passport |
Signature | | Date | |