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NHS Forms

Welsh Assembly Government

NHS Forms




Listed below are the NHS Forms that you are currently able to view for information.

The list of forms will be updated regularly with additional forms being made available in the future.

All the forms on this page are either specific to Wales or reflect Welsh issues with regard to UK National NHS Forms.

NHS Prescription Forms

You may note that a new type of prescription form, which is bilingual, is now being issued . Please continue using these new forms in the same manner as before. Large versions of the patient notes, which are found on the left hand side, of the back of the prescription form, may be found at pharmacies, or at their local G.P. surgeries .

Information on NHS Charges

Current policy

Entitlement to help with health costs (NHS prescription and dental charges, optical and hospital travel costs) is based on the principle that those who can afford to contribute should do so, while those who are likely to have difficulty in paying should be protected.
A list of current charges are contained in HC12W ' Charges and Optical Voucher Values'.

Who can get help

People can get help on age or medical grounds or by being in receipt of one of the exempting benefits or tax credits.

For more information, see HC11 'Are you entitled to help with health costs ?'. and HC81C ' Claiming Free Prescriptions Important News'.

Pharmacies and GP surgeries may have these leaflets.

Low income?

People who have to pay NHS charges may be able to get help under the NHS Low Income Scheme. The amount of help is based on a comparison between a person's income and requirements at the time that a claim is made or a charge was paid.

How do I make a low income claim?

You need to complete form HC1 - this form cannot be downloaded from the web. You must obtain a hard copy. Social Security offices and NHS hospitals should have HC1s available. Some GPs, dentists, opticians might also have them.

When you have filled in the HC1 you should send it to: Health Benefits Division, Sandyford House, Newcastle upon Tyne, NE2 1DB - in the prepaid envelope provided.

If the form you require is not listed above, you may find it at one of these linked sites: -

HC12W: Charges and Optical Voucher Values

01/06/09
This booklet gives you information about NHS charging arrangements in Wales only.
 

HC1W - Claim for Help with Health Costs

18/04/06
Do you find it difficult to pay for health costs? You may be entitled to help through the NHS Low Income Scheme
 
Are you entitled to help with health costs?

HC11W - Are you entitled to help with Health Costs?

01/09/04
This booklet gives guidance about NHS charging arrangements in Wales only.
 

HC1(SC)W - Claim for Help with Health Costs

01/08/04
If you need help or have any queries about filling in this form, you can phone our customer enquiry line on 0845 850 1166
 
Are you entitled to help with health costs?

HC10W - Are you entitled to help with health costs?

01/07/04
Pick up leaflet HC11W “Are you entitled to help with health costs?” from citizen advice bureaus, local libraries, social security offices or hospitals. Some doctors surgeries or pharmacies may have them.
 

A new Prescription for Wales

01/04/04
From 01 March 2004 you may notice something different about your prescription form.
 

Related Links

Some of the most frequently asked questions.