Nhs Gms3 99 Form PDF Details

The NHS GMS3/99 form serves as a critical tool for facilitating the provision of temporary medical services to patients who are not registered with a doctor or are away from their regular practitioners. This form is designed to ensure that individuals can receive medical attention when they are outside of their usual residence—be it for emergency treatment, contraceptive services, or other medical requirements. It requires patients to fill out their personal details in block capitals, including their NHS number, home, and temporary addresses, alongside their doctor's information. The form covers a breadth of treatment options such as minor surgical operations, treatment of fractures, general anaesthesia, and even telephone advice. The form also accommodates claims for services rendered to temporary residents, including the specification of the treatment's nature, whether it's for an initial period of up to 15 or over 15 days. Additionally, it outlines the financial aspects related to the treatment, including payments for night visits, vaccinations, immunisations, and special considerations for rural practices. With provisions for amended claims and the necessity of an audit trail for verification, the GMS3/99 form embodies a comprehensive approach to supporting temporary healthcare needs, emphasizing the health system’s adaptability and commitment to patient care regardless of their standard place of residence.

QuestionAnswer
Form NameNhs Gms3 99 Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesnhs gms3 99 temporary services form, form 99 gms3, gms3 form pdf, gms3 form download

Form Preview Example

 

 

Temporary services

GMS3/99

 

 

 

 

 

 

 

 

 

 

 

 

Please complete in BLOCK CAPITALS and tick as appropriate

Patient’s details

Mr Mrs Miss Ms

DATE OF BIRTH

NHS

No.

Home address

Date if claim sent electronically

Surname

First names

Previous surname/s

Temporary address, if applicable

Postcode

Telephone number

Postcode

Telephone number

Details of treatment should be sent to

Doctor’s name and full address

To be completed by the doctor

Emergency treatment

Minor surgical operation

Treatment of fracture

General anaesthetic

Reduction of dislocation

Other

Telephone advice only

Immediately necessary treatment

Temporary resident

Date of initial treatment

up to 15 days

over 15 days

Telephone advice only

Amended claim

Contraceptive services

non-IUD

IUD

Number of

 

 

night visits

 

 

Dental haemorrhage

Rate A

Rate B

Number of vaccinations & immunisations

fee A fee B

Rural practice payment. Distance in miles from patient’s temporary residence to my main surgery is

I declare to the best of my belief this information is correct and I claim the appropriate payment

as in the SFA. An audit trail is available at the practice for inspection by the HA’s authorised officers and auditors appointed by the Audit Commission.

Authorised signature

Practice stamp

Name

Date

 

 

Temporary services

GMS3/99

 

 

 

 

 

 

 

 

 

 

 

 

Please complete in BLOCK CAPITALS and tick as appropriate

Patient’s details

Mr Mrs Miss Ms

DATE OF BIRTH

NHS

No.

Home address

Date if claim sent electronically

Surname

First names

Previous surname/s

Temporary address, if applicable

Postcode

Telephone number

Postcode

Telephone number

Details of treatment should be sent to

Doctor’s name and full address

at: contact: queries, of case In

area tinted this on write not Do

records Clinical

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1. Begin filling out your 99 gms3 with a number of necessary blank fields. Get all of the important information and be sure absolutely nothing is missed!

Simple tips to prepare download form gms3 stage 1

2. Now that the last part is complete, you should put in the needed details in General anaesthetic, Reduction of dislocation, Other, up to days, over days, Telephone advice only, Dental haemorrhage, Rate A, Rate B, Number of vaccinations, Telephone advice only, Amended claim, fee A fee B, Rural practice payment Distance in, and I declare to the best of my belief so you're able to move on further.

Dental haemorrhage, fee A fee B, and I declare to the best of my belief of download form gms3

Those who work with this form generally get some things wrong while filling in Dental haemorrhage in this area. Be sure to re-examine whatever you type in here.

3. Completing Temporary services, GMS, Please complete in BLOCK CAPITALS, as appropriate, Date if claim sent electronically, Miss, Surname, First names, Previous surnames, Temporary address if applicable, Patients details Mr, Mrs, Date of birth, NHS No, and Home address is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Guidelines on how to fill out download form gms3 part 3

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