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Click ‘Get Form’ to open the needs medical assessment form in the editor.
Begin by entering your personal information in the 'Main Applicant’s Name' and 'Address' fields. Ensure accuracy as this information is crucial for processing your application.
Provide details of your doctor or hospital consultant, including their name, telephone number, and address. This allows the Council’s Medical Adviser to contact them if necessary.
In the 'Illness/Disability Details' section, list any medical conditions affecting you or household members. Be thorough and attach supporting letters if available.
Complete the 'Benefits and Services' section by indicating any benefits received by household members. This information helps assess your situation accurately.
Finally, review all entries for completeness and accuracy before signing the consent section at the end of the form.
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