This form is not for authorisation of treatment. Authorisation should be undertaken in the usual way with your patient contacting Customer Service.

Please note we cannot process any claims relating to cytoreductive surgery +/- HIPEC without full and complete records. In order to assess the claim accurately, we require a copy of:

• Operation notes
• Theatre logs
• Post-operative histopathology
• Anaesthetic charts

Uploaded documents must be clearly legible, or we won't be able to review your request. To keep our systems secure we can't accept documents with full stops in the file name itself. (So a file named Smith.05.05.doc, for example, needs to be renamed Smith-05-05.doc)

If you need to upload more than one document, please upload your files here