TBF Claim Form

TBF Claim Form

Before proceeding please ensure you have taken pictures, or have scans, of any documents to be uploaded as there is no option to take the picture below.

First / Last name of whom claim relates too

If claim is for a child, please state their name.

Membership Number

Address

Date of birth

YYYY

Email address

If claim is for a child, please state main members email address

Phone number

If claim is for a child, please state main members phone number

Please select

If other, please state below:

Cost of Session(s)/Appointment(s)

TOTAL

Date of Session(s)/Appointment(s)

DD/MM/YYYY format. Seperated by a comma

Please read carefully

When submitting receipts for payment, please ensure documents are on official practice stationery and include the following:

• Name of the person receiving treatment/legal advice.

• Type, cost of treatment and individual dates for each session of treatment received.

• All legal receipts must state the nature of legal advice received, and any help on the particular matter will be one-off.

• Amount paid for the treatment/legal advice.

• Name and address of the practice providing the treatment/legal advice - official letter heading or stamp. This must be within Great Britain and paid for in pounds sterling.

PLEASE NOTE: We also require separate proof of payment to accompany your practitioner receipt. This can be in the form of a debit/credit card receipt, bank statement or till receipt.

We are only able to accept block bookings once you have attended the appointments, and the receipt must state the dates and costs thereof. We are unable to reimburse the cost of a block booking before all treatments have taken place.

Unfortunately, we CANNOT accept any of the following:

• Appointments dated before your membership is active.

• Appointments or receipts for treatment/legal advice gained outside Great Britain.

• Treatments that take place at a spa, or form part of a spa visit, or any wowcher/groupon-type receipts.

• Receipts and treatments older than 6 months.

• Business cards, compliment slips and appointment cards.

• Treatment conducted by therapists not trained or registered with the relevant professional body.

Please provide all receipts and accompanying proof of payments, here.

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- I understand and require that any information provided will be kept securely and in accordance with the provisions of the Data Protection Act 2018.

- I understand that if TBF agrees to meet all or any of the costs concerned, it does so without warranting that the treatment or advice concerned is appropriate or necessary for me.

- I confirm, I have, to my best endeavours, ensured that the practitioner I used is subject to the disciplinary code of a recognised professional body and will not, in any circumstances hold TBF responsible for anything in relation to the treatment or advice.

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