Before you start
Check you're eligible to request financial assistance based on the terms of your A&E Dental Support Scheme. You can review the terms here.
Ensure you have your documentation in a format that you can digitally upload, for example, a PDF copy of your invoice or a photo of your payment receipt.
Ensure you have details of the following to hand:
The dental practice that carried out the emergency treatment
The type of treatment that was administered and when the treatment took place
Personal details of the patient
Select the appropriate Request for Assistance (RFA) form:
Benefit A: Dental accident within the UK RFA form
If the accident or emergency occurred more than 30 miles from your registered dental practice but still within the UK, please request assistance using this form.
Benefit B: Worldwide Dental Injury or Emergency treatment outside of the UK RFA form
If you were overseas (outside of the UK) and when the accident or emergency occurred and you were treated by a dentist overseas then you can request assistance using this form.
Benefit C: Consultation for dental emergency or inury
You may incur costs if the dentist has to re-open the practice to provide you with A&E dental treatment. You can request financial assistance for those costs using this form.
Benefit D: Hospital benefit or mouth cancer RFA form
If you were admitted as an in-patient to a hospital for dental treatment, or you received treatment as a result of a mouth cancer diagnosis then you can request a hospital cash benefit or assistance with the treatment cost using this form.