1. Customer
  2. Information
  3. Declaration

You can use this form to get in touch with us to make a claim for treatment, make a claim for COVID-19 cash benefit, to make a complaint, raise a query on an existing query, change your contact details or ask another question.

Please make sure you complete the questions marked with a * as we need this information to carry out security checks, and to authorise your care. Please ensure to complete this section with the details of the individual the claim relates to on your membership.

We’ll respond to claim queries as soon as we can after receiving your completed form. We’ll be in touch within two working days for all other queries.

We’re following the latest government advice to keep our people safe and asking them to stay at home and work wherever possible. Unfortunately, this means we may take longer than usual to reply.

If you’re contacting us to authorise treatment that’s within 24 hours, please call us on your usual Bupa helpline number and we’ll be happy to help.

We’re very sorry for the inconvenience and we thank you for your patience at this extremely difficult time