Upload photos or documents

If you have been asked to send a clinical photo or a document please use the upload form below. It is very simple to use.

This will then be sent to our secure NHS mailbox and any photos or documents added to you clinical record. Please do not upload documents or images unless you have spoken to our team first.

Once our clinicians have reviewed your photos or documents we will be in contact via phone or possibly video in the next 24 hours.

This form can also be used to submit your two forms of identification for online services, one must be photographic and other must provide proof of your address, such as a utility bill.

File upload

First Name *

Last Name *

Email *

Enter Email

Confirm Email *

Confirm Email

Date of birth *

Please use format day/month/year e.g. 12/05/1979

How can we contact you? *

Landline phone number

Mobile phone number

Landline phone number *

Mobile phone number *

File Upload *

Maximum file size: 10MB

Please upload your files to the practice here. We accept tiff, jpg, png, gif, txt, Word and pdf files.

Privacy Policy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

The internet is not a secure place, however, we have gone to great steps in making sure the information you submit to us is as secure as possible. We use SSL (Secure Socket Layer) certificates to encrypt the communication between your computer and our web server. If you are not completely happy to provide information via the internet please contact the practice directly.

I consent to the practice collecting and storing my data from this form.

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Valley Medical Practice New Cumnock

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