Please use your NHS email address if you have one
Specify when they will attend (or if alternative arrangements approved).
Enter the long number printed on the card.
1 x clear passport size photo and 3 x forms of ID will be required to be able to prepare your ID and Smartcard. This must include at least one of the following ID documents:
- 1 x photo, with 2 x name and address
- or 2 x photo with 1 x name and address
• Photo must be clear, with no flash reflections and no 'red eye'
• facial expression must be neutral
• must show both edges of the face clearly and must show a full front view of face and shoulders, squared to the camera.
Example of an acceptable image .
Example of unacceptable image .
ID requirements (photo ID, and, name and address):
• Photo ID must include passport/driving license or valid ID/resident card.
• Statement must include full name and address of were currently residents, must be within the last 3 months or if council tax then this years period.
• NO Mobile phone statement will be accepted.
Drop files here or click to upload
Please upload your photo and ID documents - you can upload multiple files through this upload field.
PLEASE ENSURE YOU HAVE UPLOADED YOUR PHOTO AND ID DOCUMENTS (ABOVE) BEFORE CLICKING SUBMIT.