Get Hc5 Refund Claim Form - Scottish Government

Filling out the HC5 Refund Claim Form is essential for users who wish to reclaim NHS dental charges paid. This guide will provide clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to complete your HC5 Refund Claim Form online.

1. Click ‘Get Form’ button to obtain the HC5 Refund Claim Form and open it in the editor.
2. In Part 1, provide the patient’s details including surname, forenames, address, postcode, email, title, sex, date of birth, daytime phone number, and National Insurance number.
3. Move to Part 2 to detail the NHS dental charges paid. Clearly state the amount you wish to claim for and ensure that you include original receipts. If the treatment is ongoing, submit the form within three months of the payment.
4. In Part 3, fill in the dentist's details including their name, address, and telephone number, along with the start and end dates of the treatment.
5. In Part 4, select the appropriate reason for the claim and provide necessary information. Make sure to check the corresponding box related to your eligibility for refunds.
6. Finally, review the declaration in Part 5. Ensure all information is correct. Sign and date the form, and if applicable, have the individual you're claiming for sign as well.
7. After completing the form, you can save your changes, download, print, or share the HC5 Refund Claim Form as needed.

Start filling out your HC5 Refund Claim Form online today to reclaim your NHS dental charges.