Get Dental Plan Claim Form - Boots

Filling out the Dental Plan Claim Form - Boots online is a straightforward process that requires careful attention to detail. This guide will walk you through each section of the form to ensure your claim is submitted accurately and efficiently.

Follow the steps to complete the Dental Plan Claim Form.

1. Click ‘Get Form’ button to obtain the Dental Plan Claim Form and open it for completion.
2. In Section 1, provide your personal information as the claimant. Fill in your name, policy number, address, postcode, daytime telephone number, and email address. Ensure you confirm that none of the treatment was planned prior to your policy inception and declare that all the provided information is accurate. Sign and date the section.
3. In Section 2, your dentist needs to fill in their details. This includes the date you registered with them, the date the symptoms first appeared, and the dates of any examinations you had in the last 12 months. The dentist must confirm that you received NHS dental treatment, making sure to sign and date this section as well.
4. In Section 3, provide information about the treatment you received. List the treatment types, the number of units, the dates treatment was identified, and the treatment start and end dates. Include the fees charged for each treatment type and ensure you sum all the fees to derive the total band fee charged.
5. Attach all necessary receipts as proof of payment for the treatments specified. Make sure these receipts indicate your NHS treatment details.
6. Once you have filled out all sections, save your changes. You can then download, print, or share the completed form as needed.
7. Finally, send your completed claim form to Boots Dental Plan at the designated address: PO Box 120, Cwmbran, NP44 9BE.

Get started on your Dental Plan Claim Form - Boots today to ensure your claim is processed smoothly.