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Nhs pre attendance form

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The document is a Pre-Attendance Form for patients visiting an NHS hospital, aimed at determining their eligibility for free treatment. It requires personal information, immigration status verification, and consent for data sharing with the Home Office. The form must be completed in BLOCK CAPITALS and signed by the patient or a guardian, ensuring that all details provided are accurate to avoid potential legal consequences.

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Click ‘Get Form’ to open it in the editor.
Begin by filling in your personal details in BLOCK CAPITALS. Enter your family name, first name, and date of birth accurately.
Complete the declaration section. Ensure you understand the implications of providing your information and sign where indicated.
Answer all questions under 'Personal Details'. Indicate if you usually live in the UK, provide your nationality, address, and contact information.
In the 'Official Documentation' section, check all applicable documents you hold and provide relevant details such as passport number and visa expiry date.
Fill out the 'Your Stay in the UK' section by selecting your purpose of stay and indicating any absences from the UK in the last 12 months.
If applicable, provide GP details including surgery name and NHS number.
Complete sections on health insurance and EHIC details if relevant to your situation.
Finally, review all entries for accuracy before submitting your form through our platform.

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