Please note we can only pre-authorise treatment following a consultation with a qualified GP/Physician. You must complete all fields with an asterisk (*). You will receive a confirmation email, and a member of our claims team will contact you within 24 working hours. If you need urgent medical treatment, please see our emergency contact details.
Don’t forget to upload any supporting information to the form, or alternatively, you can send any files by email to firstname.lastname@example.org