{"id":7755,"date":"2020-08-09T12:03:35","date_gmt":"2020-08-09T11:03:35","guid":{"rendered":"https:\/\/www.benshamfamilypractice.nhs.uk\/?page_id=7755"},"modified":"2020-08-09T12:04:51","modified_gmt":"2020-08-09T11:04:51","slug":"upload-photos-or-documents","status":"publish","type":"page","link":"https:\/\/www.benshamfamilypractice.nhs.uk\/your-record\/keep-us-up-to-date\/upload-photos-or-documents\/","title":{"rendered":"Upload photos or documents"},"content":{"rendered":"\n<p>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.&nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"has-background has-nhs-yellow-background-color\">This will then be sent to our secure NHS mailbox and\u00a0any photos or documents added to you clinical record.\u00a0<strong>Please do not upload documents or images unless you have spoken to our team first<\/strong>.\u00a0\u00a0<\/p>\n\n\n\n<p>Once our clinicians have reviewed your photos or documents we will be in contact via phone or possibly video in the next 24 hours.<\/p>\n\n\n<link rel='stylesheet' id='formidable-css' href='https:\/\/www.benshamfamilypractice.nhs.uk\/wp-content\/plugins\/formidable\/css\/formidableforms.css?ver=4271547' media='all' \/>\n<div class=\"frm_forms  with_frm_style frm_style_big_text\" id=\"frm_form_41_container\" >\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_js_validate  frm_pro_form \" id=\"form_hnlsj63a5bd496f23\"  >\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">File upload<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"41\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_41\" id=\"frm_hide_fields_41\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"hnlsj63a5bd496f23\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_41\" name=\"frm_submit_entry_41\" value=\"4f9d49fd65\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/wp-json\/wp\/v2\/pages\/7755\" \/><div id=\"frm_field_1019_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_first frm_half\">\r\n    <label for=\"field_xu1tj63eee17cbc4a\" class=\"frm_primary_label\">First Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_xu1tj63eee17cbc4a\" name=\"item_meta[1019]\" value=\"\"  data-reqmsg=\"First Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1020_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm_half\">\r\n    <label for=\"field_xt7az63f84b24d398\" class=\"frm_primary_label\">Last Name\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_xt7az63f84b24d398\" name=\"item_meta[1020]\" value=\"\"  data-reqmsg=\"Last Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1021_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_ppbxb634988cba13a\" class=\"frm_primary_label\">Email\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_ppbxb634988cba13a\" name=\"item_meta[1021]\" value=\"\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_ppbxb634988cba13a\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_ppbxb634988cba13a\">Enter Email<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_conf_1021_container\" class=\"frm_form_field frm_none_container frm_conf_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_conf_ppbxb634988cba13a\" class=\"frm_conf_label frm_primary_label\">Confirm Email\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_conf_ppbxb634988cba13a\" name=\"item_meta[conf_1021]\" value=\"\"  placeholder=\"Please confirm your email\" data-reqmsg=\"Confirm Email cannot be blank.\" aria-required=\"true\" data-confmsg=\"The entered values do not match\" data-invmsg=\"Confirm Email is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_conf_ppbxb634988cba13a\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_conf_ppbxb634988cba13a\">Confirm Email<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_1022_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_w1eya638ca924f6df\" class=\"frm_primary_label\">Date of birth\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_w1eya638ca924f6df\" name=\"item_meta[1022]\" value=\"\"  data-frmmask=\"99\/99\/9999\" style=\"width:200px\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"Date of birth cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" class=\"auto_width\" aria-invalid=\"false\" pattern=\"\\d\\d\\\/\\d\\d\\\/\\d\\d\\d\\d$\"   aria-describedby=\"frm_desc_field_w1eya638ca924f6df\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_w1eya638ca924f6df\">Please use format day\/month\/year e.g. 12\/05\/1979<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_1024_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_spq8l430d82b37643\" class=\"frm_primary_label\">Telephone number for us to contact you\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_spq8l430d82b37643\" name=\"item_meta[1024]\" value=\"\"  data-reqmsg=\"Telephone number for us to contact you cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_1026_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container upload\">\r\n    <div  id=\"field_d5wxb_label\" class=\"frm_primary_label\">File Upload\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/div>\r\n    <input type=\"hidden\"  data-reqmsg=\"File Upload cannot be blank.\" data-invmsg=\"File Upload is invalid\" class=\"auto_width\" aria-invalid=\"false\"   name=\"item_meta[1026][]\"  data-reqmsg=\"File Upload cannot be blank.\"  value=\"\" data-frmfile=\"1026\" \/>\n\n<div class=\"frm_dropzone frm_multi_upload frm_clearfix\" id=\"file1026_dropzone\" role=\"group\"  aria-describedby=\"frm_desc_field_d5wxb\">\n\t<div class=\"fallback\">\n\t\t<input type=\"file\" name=\"file1026[]\" id=\"field_d5wxb\"\n\t\t\t data-frmfile=\"1026\" multiple=\"multiple\"  data-reqmsg=\"File Upload cannot be blank.\" data-invmsg=\"File Upload is invalid\" class=\"auto_width\" aria-invalid=\"false\"  \t\t\t\/>\n\t\t\t\t<div class=\"frm_clearfix \"><\/div>\n\t<\/div>\n\t<div class=\"dz-message needsclick\">\n\t\t\t\t<svg  viewBox=\"0 0 18 18\" class=\"frmsvg frm-svg-icon\">\n\t<path viewBox=\"0 0 18 18\" fill-rule=\"evenodd\" clip-rule=\"evenodd\" d=\"M8.2 4v8a.8.8 0 001.5 0V4l2.1 2.2A.7.7 0 1013 5L9.5 1.7a.7.7 0 00-1.1 0L5.1 5.2a.8.8 0 001 1l2.1-2zm7.6 4.3c.4 0 .7.3.7.7v6.8c0 .4-.3.7-.8.7H2.3a.8.8 0 01-.8-.8V9A.8.8 0 013 9v6h12V9c0-.4.3-.8.8-.8z\"><\/path>\n<\/svg>\t\t<span class=\"frm_upload_text\"><button type=\"button\" aria-label=\"File Upload. Drop a file here or click to upload. Maximum file size: 5MB\">Drop a file here or click to upload<\/button><\/span>\n\t\t<span class=\"frm_compact_text\"><button type=\"button\" aria-label=\"File Upload. Choose File. Maximum file size: 5MB\">Choose File<\/button><\/span>\n\t\t<div class=\"frm_small_text\">\n\t\t\t<p>Maximum file size: 5MB<\/p>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\t\r\n    <div class=\"frm_description\" id=\"frm_desc_field_d5wxb\">Please upload your files to the practice here. We accept tiff, jpg, png, gif, txt, Word and pdf files, up to a total upload size of 5MB.<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_1027_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top frm_section_spacing\">Privacy Policy<\/h3>\r\n\r\n\r\n<div id=\"frm_field_1028_container\" class=\"frm_form_field  frm_html_container form-field\">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.<\/p>\n<p>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.<\/p><\/div>\n<div id=\"frm_field_1029_container\" class=\"frm_form_field form-field  frm_required_field frm_inline_container vertical_radio\">\r\n    <label for=\"field_4oeoa4e0ef40ca5\" class=\"frm_primary_label\"> \r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_1029-1027-0\"><label for=\"field_4oeoa4e0ef40ca5-0\"><input type=\"checkbox\" name=\"item_meta[1029][]\" id=\"field_4oeoa4e0ef40ca5-0\" value=\"I consent to the practice collecting and storing my data from this form.\"  data-sectionid=\"1027\" data-reqmsg=\"We need your consent to proceed. Please tick the box to consent.\" data-invmsg=\"  is invalid\" aria-invalid=\"false\"   aria-required=\"true\"  \/> I consent to the practice collecting and storing my data from this form.<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_1031_container\" class=\"frm_form_field form-field  frm_none_container\">\r\n    <label for=\"g-recaptcha-response\" id=\"field_71q62_label\" class=\"frm_primary_label\">reCAPTCHA\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <div  id=\"field_71q62\" class=\"g-recaptcha\" data-sitekey=\"6LcH9IUdAAAAAFZ9fTMIe9T4LEMu3SIK357qH2IA\" data-size=\"normal\" data-theme=\"light\"><\/div>\r\n    \r\n    \r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t<input name=\"frm_state\" type=\"hidden\" value=\"PXcsog+UB6vkRfvKb5JY1iDvym4RYVPBJkRHLs1RntU=\" \/><div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Send<\/button>\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n<\/form>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>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.&nbsp;&nbsp; This will then be sent to our secure NHS mailbox and\u00a0any photos or documents added to you clinical record.\u00a0Please do not upload documents or images unless you have spoken to &#8230; <a title=\"Upload photos or documents\" class=\"read-more\" href=\"https:\/\/www.benshamfamilypractice.nhs.uk\/your-record\/keep-us-up-to-date\/upload-photos-or-documents\/\" aria-label=\"Read more about Upload photos or documents\">Read more<\/a><\/p>\n","protected":false},"author":6577921,"featured_media":7757,"parent":94,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","_uag_custom_page_level_css":"","footnotes":"","_links_to":"","_links_to_target":""},"acf":[],"uagb_featured_image_src":{"full":["https:\/\/www.benshamfamilypractice.nhs.uk\/wp-content\/uploads\/2020\/08\/9eid2zc_veo-scaled.jpg",2400,1600,false],"thumbnail":["https:\/\/www.benshamfamilypractice.nhs.uk\/wp-content\/uploads\/2020\/08\/9eid2zc_veo-150x150.jpg",150,150,true],"medium":["https:\/\/www.benshamfamilypractice.nhs.uk\/wp-content\/uploads\/2020\/08\/9eid2zc_veo-300x200.jpg",300,200,true],"medium_large":["https:\/\/www.benshamfamilypractice.nhs.uk\/wp-content\/uploads\/2020\/08\/9eid2zc_veo-768x512.jpg",768,512,true],"large":["https:\/\/www.benshamfamilypractice.nhs.uk\/wp-content\/uploads\/2020\/08\/9eid2zc_veo-1024x683.jpg",1024,683,true],"1536x1536":["https:\/\/www.benshamfamilypractice.nhs.uk\/wp-content\/uploads\/2020\/08\/9eid2zc_veo-1536x1024.jpg",1536,1024,true],"2048x2048":["https:\/\/www.benshamfamilypractice.nhs.uk\/wp-content\/uploads\/2020\/08\/9eid2zc_veo-2048x1365.jpg",2048,1365,true],"mailpoet_newsletter_max":["https:\/\/www.benshamfamilypractice.nhs.uk\/wp-content\/uploads\/2020\/08\/9eid2zc_veo-1320x880.jpg",1320,880,true]},"uagb_author_info":{"display_name":"Editor","author_link":"https:\/\/www.benshamfamilypractice.nhs.uk\/author\/gary-genpra\/"},"uagb_comment_info":0,"uagb_excerpt":"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.&nbsp;&nbsp; This will then be sent to our secure NHS mailbox and\u00a0any photos or documents added to you clinical record.\u00a0Please do not upload documents or images unless you have spoken to&hellip;","publishpress_future_action":{"enabled":false,"date":"2024-05-05 15:53:15","action":"change-status","newStatus":"draft","terms":[],"taxonomy":""},"_links":{"self":[{"href":"https:\/\/www.benshamfamilypractice.nhs.uk\/wp-json\/wp\/v2\/pages\/7755"}],"collection":[{"href":"https:\/\/www.benshamfamilypractice.nhs.uk\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.benshamfamilypractice.nhs.uk\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.benshamfamilypractice.nhs.uk\/wp-json\/wp\/v2\/users\/6577921"}],"replies":[{"embeddable":true,"href":"https:\/\/www.benshamfamilypractice.nhs.uk\/wp-json\/wp\/v2\/comments?post=7755"}],"version-history":[{"count":0,"href":"https:\/\/www.benshamfamilypractice.nhs.uk\/wp-json\/wp\/v2\/pages\/7755\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.benshamfamilypractice.nhs.uk\/wp-json\/wp\/v2\/pages\/94"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.benshamfamilypractice.nhs.uk\/wp-json\/wp\/v2\/media\/7757"}],"wp:attachment":[{"href":"https:\/\/www.benshamfamilypractice.nhs.uk\/wp-json\/wp\/v2\/media?parent=7755"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}