Use this form if you need any of the following:
- NHS dental treatment
- sight tests, glasses or contact lenses
- travel to receive NHS treatment under the care of a consultant
- you live permanently in a care home and a local authority helps you with the cost of your accommodation or
- you are supported by a local authority because you have recently left local authority care
You can request a printed copy of this form via email or by calling the publications order line on 0345 603 1108.