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Patient Transport Service Booking Form Billing Details Billing Name: Purchase Order Number:(If Applicable) Name of person responsible for paying invoices. Billing Address: Where to send the invoice.

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How to fill out the Patient Transport Service Booking Form online

This guide provides a detailed overview of the Patient Transport Service Booking Form to assist users in completing it online. Follow the step-by-step instructions to ensure all necessary information is accurately provided.

Follow the steps to complete the booking form effectively.

  1. Click ‘Get Form’ button to access the Patient Transport Service Booking Form online and open it in the editor.
  2. Enter the billing details: Provide the billing name of the person responsible for invoices, along with a purchase order number if applicable. Fill in the complete billing address including the relevant contact telephone number, email address, and fax number.
  3. Fill out the journey details: Include the complete collection location address and the destination address, making sure to add the post codes where possible. Specify the journey date and preferred pickup time.
  4. Select the type of vehicle required: Choose from options including emergency ambulance, transport ambulance, emergency car, or transport car. Indicate the required crew skill level such as fully qualified emergency, intermediate transport, patient transport, or single EMT/ACA.
  5. Provide booking contact details: Fill in the name and contact telephone number of the person making the booking, as well as the date and time the booking is made. Include the fax number if required.
  6. Complete patient details: Enter the patient's full name and date of birth. If applicable, provide the hospital number and include any relevant medical conditions, access requirements, or infectious diseases.
  7. Indicate the patient's mobility level: Select either fully independent, mobile with assistance of one person, mobile with assistance of more than one person, or unable to mobilize. Confirm whether they will be accompanied by medical personnel or relatives.
  8. Review all information before signing and entering the date. Ensure clarity and accuracy in the provided details.
  9. After you have filled out the form, you can either save the changes, download, print, or share the completed form as necessary.

Complete your Patient Transport Service Booking Form online today to ensure timely arrangements.

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Contact support

Please telephone 0800 0323240 if you need to cancel your transport. Please note: If you are a patient living in Greater Manchester and need to cancel your first appointment, please ring the booking centre which you booked from. Bookings will be treated as cancelled from the time of the call.

How do I book patient transport? You, or a nominated person (carer) on your behalf, should call E-zec Medical on 0300 777 6688. You will need your NHS number when calling. If you don't know it, you can ask for it from your GP surgery or healthcare professional.

You can call the booking line number – 0800 0323 240 to make a general enquiry.

5 Tools and Tips for Safely Transporting Patients Use a “Ticket to Ride” ... Correctly Identify the Patient. ... Bring Appropriate Equipment. ... Nitrile Gloves. ... Using Transfer Boards or Rollers for Bed-Ridden Patients. ... Incorporate Gait Belts for Mobile Patients.

These services provide free transport to and from hospital for: people whose condition means they need additional medical support during their journey. people who find it difficult to walk. parents or guardians of children who are being transported.

Any patient who would like advice on patient transport can contact NHS Cumbria's Patient Advice and Liaison Service (PALS) on 0300 123 9006 and leave a message for someone to call them back. Before you ask for NHS transport please consider other ways to get to your appointment such as: using your own car.

In an emergency In a medical emergency, call 999 and ask for an ambulance. You will not have to pay to be taken to hospital in an emergency. A medical emergency is when someone is seriously ill or injured and their life is at risk.

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