You can pick up an HC1 claim form from a Social Security office or NHS hospital. Your doctor, dentist or optician may have one too. You can also request a form by telephoning 0845 850 1166
 
 


Please Note

If you have not read our statement relating to the use of your personal information please do so now.

Orange fields are mandatory - Please complete all mandatory fields. (also marked with a * for older browsers)
*Forename
*Surname
*Title
   

*Address		 (house number and street name)
*Town
County
*Postal Code


If you wish to claim money back for health costs you have already paid, please tick the box(es) appropriate to the charge(s) you have paid. We will send you the appropriate HC5 form which you should also complete.
Dental
Sight Test/Glasses/Contact Lenses
Travel for NHS Treatment

If you have paid for Wigs/Fabric Supports then click here to download the claim form

 

  
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