“HelpwithHealthCosts”availabletodownload at:.nhs.uk/healthcosts.Ifyouhaveanyqueriesorneedhelpfillinginthisformyoucanspeakto anadvisorattheNHSBusinessServicesAuthorityon08458501166. YOURCLAIMCANNOTBEACCEPTED... HOWTOCLAIMFORSOMEBODYELSE TIMELIMITFORCLAIMING MOREREFUNDINFORMATION HC5(O) Usethisformtoclaimback...