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- Click ‘Get Form’ to open the hsf claim form in the editor.
- Begin by filling in your surname and forenames in BLOCK LETTERS. Ensure accuracy as this information is crucial for processing your claim.
- Provide your address details clearly. This section is essential for correspondence regarding your claim.
- Sign the form where indicated, and include your registration number and date. This confirms your identity and authorizes the processing of your claim.
- In Section B, answer all questions thoroughly regarding your diagnosis, symptoms, and previous consultations. Missing information may delay settlement.
- Complete the patient details in Section C, including their name and date of birth. If applicable, indicate if they are a spouse/partner or child under 18.
- For claims related to day case surgery/treatment, fill out Section D with hospital details and ensure an authorized hospital official signs it.
- In Section E, tick the appropriate boxes for the nature of your claims and ensure you enclose all required receipts as originals.
- Finally, review all sections to confirm completeness before submitting the form back to Clare Road Mall.
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hsf claim form online
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