explains the approach to privacy in concise, easy to understand and clear language. Practices may
wish to ask patients to sign this to confirm opt in consent instead of using individual consent forms.
If you wish to use the Privacy Notice to obtain opt in consent, make sure that you list everything you
want consent for and ask the patient to consent to each item, usually by ticking a box and then
signing at the end. You will need to add this list in yourself. You will also need to add a signature line
for the patient to sign to signify that they give consent to each item. Note: Boxes must never be pre-
You should retain a copy of the signed notice at the practice and give the patient a copy.
Alternatively, you can use the Apolline draft consent forms.
This information has been prepared exclusively for use in Apolline clients’ practices and as such
should not be shared with anyone else. The information was prepared to reflect our thinking on what
is required for data protection. It is not definitive guidance and Apolline Ltd accepts no responsibility
for the validity or correctness of this document or any consequences arising as a result of its use by
practices. Practices should obtain independent legal advice regarding their personal situation should
they require definitive advice and guidance.
Important note: This cover page is designed to explain the patient Privacy Notice and as such should
not be given to the patient.