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Email is the best way to reach us - no hold times, and you'll typically have your queries answered within 48 hours.

Send us an email

Provider specific information

Additional information

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Confirm patient membership details

Provider name

This is the practitioner, hospital or clinic providing the service

Email address

Contact name

Are you confirming membership details for more than 1 patient?

Yes No

Patient's plan number

Patient's name

Patient's date of birth

Day

Month

Year

Patient's postcode

Enter address manually

Select address

First line

First line is required

Second line

Third line

Town/City

Town/City is required

County

Postcode

Postcode is required

Claim number

Procedure/Treatment date

Which system are you using to submit your invoice?

Healthcode Vitality submission form

Please note

You need to download the template spreadsheet to provide all of your patient's details. Then upload the spreadsheet below.

Download template spreadsheet

Supporting documents

You can upload a maximum of 5 files
Acceptable file formats include: PDF, JPG, JPEG, PNG, XLS, XLSX, DOC and DOCX
Maximum file size must not exceed 5MB

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