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Hospital admission form 2026

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  1. Click ‘Get Form’ to open the hospital admission form in the editor.
  2. Begin by filling in your personal and administration details. Enter your surname, first name(s), date of birth, preferred name, gender, NHI number, residential address, postal address, email address, and telephone numbers.
  3. Next, provide information about your ethnicity and general practitioner. Make sure to circle one or more options for ethnicity and include the GP's contact details.
  4. In the next of kin/contact person section, enter their name, relationship to you, address, and telephone numbers.
  5. For payment details, indicate how your procedure will be paid for by ticking the appropriate boxes. Fill in any required insurance information if applicable.
  6. Review the agreement section carefully. Ensure you understand your responsibilities regarding payment and consent before signing and dating the form.

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