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Declaration of Parental Responsibility
In line with Department of Health Guidance, it is important that we hold a record of those people who have parental responsibility for all the children (under 16 years) registered with our surgery.
By parental responsibility, we mean all the rights, duties, powers and responsibilities which by law a parent has in relation to a child. This will include any of the following:
- The child’s mother
- The child’s father if married to the mother at the time of the birth, or if they married after the birth.
- The father if he co-registered the child’s birth with the mother and the registration took place after 1.12.2003
- The father if he has registered a Parental Responsibility Agreement with the court
- A civil partner:
- if she is in a civil partnership with the mother at the time of the birth
- if she registers a civil partnership with the mother later on,
- if she is on the UK birth certificate
- if she and the mother have signed a parental responsibility agreement, which is a prescribed form, and lodged it with the court; or
- if the court has made a parental responsibility order in her favour.
- A person granted a court order under the powers of the Children Act 1989
- A person who has been appointed a guardian by the court under the Children Act 1989
Please complete the form, letting us know who has parental responsibility for your child.
This information will be held on your child’s medical record. If there are any changes to the details, you should let us know.
If you have any queries, please get in touch via the Contact Us Form.
Declaration of Parental Responsibility Form
Privacy Consent
- This form collects personal and medical information about you and we use this information to allow the practice team to contact you.
- Please read our Privacy Policy to discover how we protect and manage your submitted data.
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