Defib1 2026

1. Click ‘Get Form’ to open the defib1 document in the editor.
2. Begin with Part A: About You. Fill in your title, surname, first name(s), date of birth, driver number (if known), address, telephone numbers (home and mobile), postcode, and email using BLOCK CAPITAL letters and BLACK INK.
3. Proceed to Part B: About Your GP and Your Consultant. Enter your GP’s name and address, consultant's name and address, their contact numbers, and the dates you were last seen by them regarding your condition.
4. In Part C, provide details of any other clinics you are attending. Include the clinic's name, department, reason for attendance, date last seen, and any relevant reference numbers.
5. Complete the questionnaire section by answering questions about your cardiac defibrillator (ICD). Ensure you provide accurate dates if applicable.
6. Sign the declaration confirming compliance with conditions for driving with an ICD. Fill in your name, date of birth, driver number, and sign at the designated area.
7. Review all sections for completeness before submitting your form via post or fax as instructed on the final page.

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