There are four groups listed in this section. You need to tick which one applied to you at the time you paid for your NHS wig or fabric support costs. If you're unsure about which benefit you receive look at your benefits award notice or contact your benefits office.
you receive a War Pension payment or an Armed Forces Compensation Scheme payment and you were being treated for your accepted disablement.
Send your HC5(W) form to: Service Personnel and Veterans Agency,
Norcross, Blackpool, FY5 3WP.
you are named on an HC2 or HC3 certificate, or
If your name was on an HC2 or HC3 certificate, tick this box and write the number of the certificate and the name and date of birth of the certificate holder.
Send your HC5(W) form to: NHS Business Services Authority, Bridge House, 152 Pilgrim Street, Newcastle upon Tyne, NE1 6SN.