Get Application Form - Healthy Start

This guide provides a step-by-step approach for filling out the Application Form for Healthy Start vouchers online. It aims to assist users in completing the form efficiently while ensuring all necessary information is included.

Follow the steps to complete the Application Form effectively.

1. Click ‘Get Form’ button to access the Application Form - Healthy Start and open it for editing.
2. In the 'You' section, enter your personal details including your title, surname, first name, date of birth, and National Insurance number. Ensure this information is accurate and written in capital letters using black ink.
3. Tick all applicable benefits you are currently receiving from the provided options. This helps determine your eligibility for the Healthy Start vouchers.
4. In the 'Your address and telephone number' section, provide your full address and current phone number, ensuring that all information is complete and correctly formatted.
5. If applicable, fill in the details of your partner who resides with you, including their personal information and the benefits they receive.
6. If you are under 18 or a full-time education student under 20 and living with a carer, fill in their details and benefits in the designated section. If they have a partner, include that information as well.
7. Complete the section if you are aged 18 or 19, in full-time education, and pregnant. Indicate if you are included in your carer’s or carer’s partner's claim for benefits.
8. Provide the details of any children under the age of four in the specified section. If you need more space, continue on another sheet of paper.
9. Indicate if you are currently pregnant by selecting 'Yes' or 'No.'
10. Sign and date the form yourself if you are 16 or older. If under 16, have a parent or carer sign the form.
11. Read and agree to the terms stated in the form before submitting it, ensuring you understand the responsibility of the information provided.
12. Request your health professional to complete their section of the form, including their signature and necessary information. This part is essential for processing your application.
13. Upon completion, ensure all fields are filled out correctly, then save your changes. You can download, print, or share the form as required.

Complete your Application Form - Healthy Start online today to ensure you receive the support you need.