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HC5(D) Claim Form For a Refund of NHS Dental Charges Please read this page before filling in this form - it will help you make this claim correctly. Use a separate form for each person who has paid.

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Dental treatment is free if you or your partner receive any of these benefits: Guarantee credit part of Pension Credit. Income Support.

If you have paid an NHS dental charge you must receive a receipt, either an NHS receipt form FP64 or another receipt which shows the amount of the NHS charge and the date you paid it. To claim a refund you must complete this form and include all original receipts.

travel costs to receive NHS treatment. Please read this page before filling in this form - it will help you make this claim correctly. Use a separate form for each person who has paid travel costs or has had travel costs paid for them. Part 4 tells you where to send the completed form.

If you have paid an NHS dental charge you must receive a receipt, either an NHS receipt form FP64 or another receipt which shows the amount of the NHS charge and the date you paid it. To claim a refund you must complete this form and include all original receipts.

You are entitled to free NHS dental treatment if your annual family income used to work out your tax credits is £15,276 or less and you receive either: Child Tax Credit. Working Tax Credit and Child Tax Credit paid together. Working Tax Credit including a disability element.

speak directly to the dental professional concerned, or the practice that provided the treatment. explain why you are unhappy with the treatment. state how you would like the matter resolved.

NHS dental charges The current charge is £23.80 in England and £14.70 in Wales. Treatment covers: an examination, diagnosis and care to prevent problems. if necessary, X-rays, scale and polish and planning for more treatment.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232