Get Hc5 Form

This guide provides clear instructions on how to complete the Hc5 Form online to claim refunds for optical costs. Follow these steps carefully to ensure a smooth submission process.

Follow the steps to successfully fill out the Hc5 Form online.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Begin by filling in Part 1 with the patient's details, including surname, other names, title, date of birth, National Insurance number, address, postcode, email address, and telephone number.
3. In Part 2, provide details of the optical charges paid. Indicate the amount for the sight test, include the date, and specify the amount for glasses or contact lenses. Attach original receipts and the optical prescription.
4. In Part 3, list the name, address, and telephone number of the optical practice from which the services were received.
5. Complete Part 4 by selecting the appropriate group indicating eligibility for the claim. Provide required information as asked for each group.
6. Sign and date the declaration in Part 4A if you are claiming for yourself, or in Part 4B if you are signing on behalf of someone else.
7. Ensure all sections are filled out correctly. Save changes, and download, print, or share the completed form as needed before submission.

Start filling out the Hc5 Form online today to claim your optical cost refunds.