HCA UK Patient Referral Form

This is the digital version of your referrals form as set out in Schedule 1 of your contract.

The submission by the Advisor of a Referral Form is not intended and shall not constitute a binding agreement between the parties nor shall it fetter in any way HCA’s absolute discretion to determine to whom it shall provide Healthcare Services.

The submission of this Referral Form is also confirmation that the Advisor has obtained all necessary consents for the sharing of personal data with HCA by the proposed patient and that data is being processed in accordance with the UK General Data Protection Regulation and the Data Protection Act 2018.

For the avoidance of doubt, only referrals submitted prior to admission date will be eligible for the Advisor Service Fee.

If you have any questions please contact your international business relations manager or send an email to internationalreferrals@hcahealthcare.co.uk