Send an SR1 medical evidence form
Send medical evidence to support a benefit claim made with the Special Rules for end of life (SR1 form)
Applies to England, Scotland and Wales
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You can send medical evidence with an SR1 form to support a benefit claim made with the Special Rules.Ìý
In most cases, the Special Rules allow people nearing the end of life to:Ìý
- get faster, easier access to certain benefitsÌý
- get higher payments for certain benefitsÌý
- avoid having an in-person medical assessment
Use this service to send an SR1 form to the Department for Work and Pensions if you have a patient who:Ìý
- has a progressive diseaseÌý
- you would not be surprised if they were to live for less than 12 months
There is a different process for healthcare professionals to�.
Who can send an SR1 formÌý
To send an SR1 form, you must be a:Ìý
- ³¦´Ç²Ô²õ³Ü±ô³Ù²¹²Ô³ÙÌý
- general practitionerÌý
- hospice doctorÌý
- senior specialist nurse (such as a clinical nurse specialist, advanced nurse practitioner)Ìý
- specialty doctorÌý
There are no negative consequences for the clinician or patient if a patient who claims under the Special Rules lives longer than expected.Ìý
General practitioners and GMC-registered consultants can claim a fee for completing an SR1 form.Ìý
Send an SR1 formÌý
You can send an SR1 form online, by email or by post.Ìý
What you will needÌý
You will need to tell us the patient’s:Ìý
- name, date of birth and addressÌý
- diagnosis and other relevant conditionsÌý
- date of diagnosisÌý
- awareness of their diagnosis and prognosisÌý
- date they are thought to have met the criteria for the Special RulesÌý
- clinical features that indicate a severe progressive conditionÌý
- treatment planÌý
You do not need to give a specific prognosis. Use the same language you use when communicating with other clinicians.Ìý
You will also need to tell us your:Ìý
- ²Ô²¹³¾±ðÌý
- °ù´Ç±ô±ðÌý
- professional registration numberÌý
- organisation’s phone number and addressÌý
Send onlineÌý
Send by emailÌý
·¡³¾²¹¾±±ôâ€�[email protected] to request an electronic version of the SR1 form and fee form.Ìý
Your email must be from a secure email address and include your:Ìý
- surgery, hospital, or office addressÌý
- phone numberÌý
Secure email addresses end in:Ìý
- °ª²Ô³ó²õ.²Ô±ð³ÙÌý
- °ª²Ô³ó²õ.³Ü°ìÌý
- °ª²Ô³ó²õ.²õ³¦´Ç³ÙÌý
- °ª²Ô³ó²õ.·É²¹±ô±ð²õ.³Ü°ìÌý
- °ª²µ´Ç±¹.³Ü°ìÌý
Emails not sent from a secure email address will be automatically deleted.Ìý
You can save the SR1 form to your device. You do not need to sign either of the forms.Ìý
Email the completed SR1 forms toâ€�[email protected].Ìý
Do not encrypt any part of the email.Ìý
Send by postÌý
You can order paper SR1 forms usingâ€�the DWP order form.Ìý
Post completed paper SR1 forms and fee forms to:Ìý
Personal Independence Payment (10)Ìý
Mail Handling Site AÌý
°Â´Ç±ô±¹±ð°ù³ó²¹³¾±è³Ù´Ç²ÔÌý
WV98 1AEÌý
You must:Ìý
- sign the completed formÌý
- post the original copyÌý
- use a separate envelope for each patient’s formÌý
Alternatively, you can give the completed SR1 form to the patient or the person who requested it on their behalf. You must still post the fee form to us.Ìý
We cannot accept a printed copy of the electronic SR1 form.Ìý
Do not staple any documents together.Ìý
Get helpÌý
·¡³¾²¹¾±±ô:â€�[email protected]Ìý
We aim to respond within 3 working days.Ìý