Free Initial Enquiry for NHS Continuing Healthcare

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Information Hub
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- Introductory Callback

Free Initial Enquiry

Free Email Enquiry

Use this form to request a free, confidential and no-obligation view on your NHS Continuing Healthcare (CHC) position. You may be exploring CHC for the first time, responding to a review, dealing with funding that has been withdrawn, or considering an appeal. Providing as much detail as you can will help ensure a clearer, more informed response.

Please complete this short form to assist us in evaluating potential eligibility for NHS Continuing Healthcare:

Your Name *

First

Last

* Indicates required field

Your Email *

Your Phone Number *

Please only leave your phone number if you would like to be contacted by phone

What is your relationship to the patient? *

Please select from the drop down menu

If 'other' please state: *

What county is the patient currently permanently resident in? *

Enter county

Do you hold Lasting Power of Attorney or a Deputyship Order for the patient? *

Yes No Other

If 'other' please explain below: *

Does the patient have difficulty with or require help with any of the following? *

Breathing Eating Toileting Skin integrity e.g. pressure sores Mobility Communication Psychological and Emotional Needs Cognition e.g. dementia Challenging behaviour e.g. aggression or resisting care Managing pain and taking medication Dizziness, blackouts, mini strokes Other (please describe below)

Please select all that apply

If 'other' please describe: *

Does the patient require 24-hour care? *

Yes No

Where is the patient currently being cared for? *

In residential care In hospital At home In hospice care Other

If 'other' please state: *

Please provide a brief summary of the patient’s health needs and the care required to address them. The more detail you are able to provide, the better. *

The data I submit will be collected and processed in accordance with ARROW’s Privacy policy. I understand that it will not be used for any purposes other than those specified. *

Yes

Submit

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ARROW Continuing Healthcare Consultants
Proprietor: Dr Ros Setterfield: PhD in Law; PGDip (Legal Studies); BA (Hons)

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