Privacy Web Form

Welcome to the Data Subject Access Request form which enables you to request access to your Personally Identifiable Information held or processed by The London Clinic (TLC).

Please be aware that;

TLC will do its upmost to fulfil these requests within 30 day of receiving this application. If your request will take longer than 30 days to process, TLC will notify you of any changes to your application timeframe.
You will receive a confirmation upon TLC receiving this application within 72 hours, if this is not acknowledge within this time frame please email dataprotection@thelondonclinic.co.uk
This application may need to be directed to a consultant and/or third party rather than to TLC, in these instances we will inform you of this and provide reasonable support in notifying the consultant of this request.
Please ensure that all relevant information is included in this form to ensure we will fulfil your request within the application timeframe.
Please attach the relevant documents to the attachment portal below if you need to provide additional information about your request.

I am a (an)

First Name

Enter the first name of the data subject

Last Name

Enter the last name of the data subject

Address

Postcode

Enter email for correspondence with the data request.

Phone Number

Date of Birth

Does this request require a date range ?

Patient/Hospital 'L' Number

Please provide if know.

Country

Enter country of residence.

Name of Consultant

(if known)

Request Details

Enter any additional information in this section that will help us process your request. Please refrain from entering any personal information.

Please Note

URL provided - Privacy Notice and what users can add to SAR form

If you are unsure of what you can include in your SAR submission form, click here for more information.

Click on the following links for more information about TLC General and Patient Privacy Notice