Get Uk Defib1 2018-2025

The UK DEFIB1 form is essential for individuals with an implantable cardioverter defibrillator seeking to inform the relevant authorities about their medical condition. This guide provides clear instructions on how to accurately complete the DEFIB1 form online, ensuring that your information is correctly submitted.

Follow the steps to successfully complete your DEFIB1 form.

1. Press the ‘Get Form’ button to access the DEFIB1 form and open it in your editor.
2. In Part A, provide your personal information. Fill in your title, surname, date of birth, first name(s), driver number (if known), address, telephone numbers (home and mobile), postcode, and email address. Ensure all fields are completed in BLOCK CAPITAL letters using BLACK INK.
3. In Part B, enter details about your GP and consultant. Include their names and addresses, as well as their contact numbers and email addresses (if known). Also, provide the dates of your last visits to both the GP and consultant regarding your condition. If you have multiple consultants, document their details on a separate sheet.
4. In Part C, list any other clinics you are attending. Include the name of the clinic and department, along with the reason for attendance and the date you were last seen.
5. Move to the medical questionnaire section regarding your implantable cardioverter defibrillator (ICD). Answer whether you have had an ICD fitted solely for preventative reasons, and if yes or no, provide the date when the ICD was fitted or delivered shock therapy as applicable.
6. Respond to the questions regarding your healthcare professional. Confirm whether you agree to attend regular medical reviews with your cardiologist or a clinic they supervise.
7. Complete the applicant's declaration section. Carefully read through the information provided about fitness to drive and authorize your doctor(s) and specialists to release relevant medical information to the Secretary of State's medical adviser. Sign and date this section.
8. Indicate your preferences for communication regarding your application by ticking the appropriate boxes for email or SMS contact. Make sure to provide your consent where applicable.
9. After filling out all sections, review the information for accuracy. Save your changes, then download, print, or share your completed DEFIB1 form as needed.

Complete your DEFIB1 form online now to ensure your medical information is accurately recorded.