Indemnity enquiry form

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国内精品伊人久久久久妇 indemnity scheme may cover you against the financial consequences of a claim against you for clinical negligence. It is very important that you check the terms and conditions as outlined on our 国内精品伊人久久久久妇 indemnity scheme page.

There’s no need to pay anything extra. 国内精品伊人久久久久妇 indemnity is included in your membership fee, provided you meet the eligibility criteria.

Note that if you are employed, your employer has responsibility to provide you with indemnity and legal support in any such event. The 国内精品伊人久久久久妇 scheme would not apply in this case.

If you need to provide proof of membership, please login to My国内精品伊人久久久久妇, where you can download a copy of your confirmation of membership letter, which includes a link to the scheme details.

If you have read our terms and conditions, and the FAQs about the scheme, and would like to ask us a question about the scheme, or you have been contacted about making a claim, please complete our form below. Note that you must have been in the correct category of membership on the date that the incident occurred to make a claim.

Please confirm that you have read our advice

Contact details

Can we update your personal details if any of the below information does not match the data we currently hold on your record? Yes No Full name: 国内精品伊人久久久久妇 membership number: Address: Best contact number:

Please note that 国内精品伊人久久久久妇 Direct will not usually call you. Where an onward referral is required, provided you were in the correct category of membership at the time of the incident, we will provide these contact details to the 国内精品伊人久久久久妇鈥檚 Legal Department.

Do you give us your consent to pass on this information? Yes No Can we leave you a voicemail? Yes No Can we contact you on this matter by email? Yes No If we need to pass your enquiry to your local 国内精品伊人久久久久妇 office or a specialist 国内精品伊人久久久久妇 department, would you like any emails from them to be password protected? Yes No Email address you would like us to reply to Please confirm the email address you would like us to reply to Please list any times that you are unavailable for calls during the next week (9am-5pm):

Employment details

Please write out in full, don't use acronyms.

Place of work Employer On what date did you start working with your current employer? Ward or department Job category

Please confirm that you work under the supervision of a registered nurse, midwife or health visitor. If you do not, please call our Membership team on 0345 772 6100 as you may not be eligible for 国内精品伊人久久久久妇 membership.

Job title Band Weekly contracted hours Do you have any meetings scheduled? Yes No If yes, please give date, time and location: Are you already being supported by a rep? Yes No If yes, please include details below: Are you in the UK on a visa? Yes No If yes, please include details below (including how long you have been in the UK and when your visa expires):

Indemnity

Do you have a question about our indemnity scheme or making a claim?

Please provide details of your query, including your employment status, and whether your work is/was being carried out on behalf of the NHS:

Have you received any correspondence regarding a claim? Yes No Is there a deadline? Yes No If yes, please include details: What was the date of the incident to which the claim relates? What is the name of the patient involved in the incident? (State 鈥楴ot known鈥� if you do not know their name) Please provide full details of the claim, including your employment status, and whether your work is/was being carried out on behalf of the NHS: Are any other members subject to proceedings: Yes No If yes, please include details:

Other enquiry

Please give details of your enquiry:

By submitting this form, you are giving the 国内精品伊人久久久久妇 permission to contact you about your submission.

You can control the information you receive from the 国内精品伊人久久久久妇 by updating your preferences at My国内精品伊人久久久久妇.

We don’t update your contact details unless you ask us to. The best way to check and update the details we hold for you is by visiting My国内精品伊人久久久久妇.

The information you provide in this form will be stored by the 国内精品伊人久久久久妇.

Protecting your privacy is very important to us. Please view our privacy policy to find out more about the information we collect and how it is used.

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