Test and Trace Support payment document upload

Information

The unique 8 digit NHS Account ID, if one has been issued:

National Insurance number:

Upload

Please note, the maximum total size you can upload is 12Mb.

Choose a file:

Upload

The total file size of the documents you are trying to upload is too high. Please remove files so that the total is less than 12MB.

If you need to add more files please fill in this form again after you have submitted it

Your contact details

Title: *

First name: *

Surname: *

House name/number:

Postcode: *

Phone number:

If we need to phone you our number will show as withheld.

Email address:

Please note that we may use your email address for future correspondence.

Please enter a valid email address or leave blank if you do not have an email address

Your documents will be uploaded to our system - this may take a few minutes depending on your connection speed.

Data Protection

The information you have provided on this form will be used to deal with your request by the relevant department. We may pass your details on to contracted third party service providers. We will store a copy of your completed request as a backup for 12 months.

If you would like to know more about how we use your information and how you can exercise your information rights please see our privacy notice.

Please note, we reserve the right to request original documents in certain circumstances

Please tick to confirm you accept these conditions.