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How to fill out the Hc5t Form online
The Hc5t Form is used to claim a refund for travel costs incurred while receiving NHS treatment. This guide provides clear instructions on how to fill out the form online, ensuring that you complete your claim accurately and efficiently.
Follow the steps to successfully fill out the Hc5t Form online.
- Click ‘Get Form’ button to obtain the form and open it in the online editor.
- In Part 1, provide the patient's details, including surname, other names, title, date of birth, National Insurance number, address, postcode, daytime contact number, and local NHS Clinical Commissioning Group.
- In Part 2, indicate the travel costs paid. Specify the refund amount, dates of attendance, and any accompanying escort costs. Ensure to attach any relevant tickets or fuel receipts.
- In Part 3, provide details about the department attended and the healthcare professional who made the referral. Include the name, complete address, and telephone number of the treatment facility.
- In Part 4, state the patient’s income at the time of travel. Tick the applicable box and provide necessary information regarding benefits or certificates. Make sure to send the form to the correct office based on the information provided.
- Finally, in Part 4, sign and date the declaration, confirming that all information is accurate. If filling out the form for someone else, ensure they also provide their signature.
- After filling out all sections, save changes and choose to download, print, or share the form as needed.
Complete your Hc5t Form online to claim your travel refunds today!
You should send the completed HC5 form to the address specified on the form itself. This address is designated for processing refund claims. To ensure your submission arrives safely, consider using a tracked mailing service. Properly addressing your envelope helps expedite the handling of your claim.
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