Registration, variation and cancellation forms and guidance

This page contains information and links to independent healthcare registration, variation and cancellation forms and appendices.

New application for registration forms and guidance have been developed for first time applicants. All new applicants will need to complete Forms R1, R1SOP, R1A (if you are required to have a registered manager) and all relevant self-assessment forms. All applicants are strongly urged to read the guidance documents available.

All new applicants will need to read the guidance on applying for registration and complete Form R1.

Guidance on applying for registration

Guidance on applying for registration (pdf 245kb) (opens new window)

Estates guidance for applicants (pdf 46kb) (opens new window)

Guidance for independent healthcare providers on minor and material major variations (pdf 47kb) (opens new window)

Hub and spoke registration Frequently asked questions (FAQs) (pdf 43kb) (opens new window)

Procedures For The Approval Of Independent Sector Places For The Termination Of Pregnancy (pdf 75kb) (opens new window)

Registration forms

All new applicants are required to complete Forms R1, R1SOP, R1A (if you are required to have a registered manager) and all relevant self-assessment forms. You must also ensure that you send all of the information we require, set out in the checklist in the front of form R1, with the application.

Form R1: Application for registration (pdf 155kb) (opens new window)
Form R1: Application for registration (doc 285kb) (opens new window)

Form R1SOP: Statement of purpose (pdf 147kb) (opens new window)
Form R1SOP: Statement of purpose (doc 197kb) (opens new window)

Application for registration - supplementary sheet (pdf 24kb) (opens new window)
Application for registration - supplementary sheet (doc 49kb) (opens new window)

Medical check form (pdf 40kb) (opens new window)
Medical check form (doc 48kb) (opens new window)

Financial report form (pdf 51kb) (opens new window)
Financial report form (doc 55kb) (opens new window)

Professional reference form (pdf 50kb) (opens new window)
Professional reference form (doc 56kb) (opens new window)

Pre-registration self-assessment forms: Pre-interview form: manager and applicants who will be in day-to-day charge of the establishment/agency (pdf 49kb) (opens new window)
Pre-registration self-assessment forms: Pre-interview form: manager and applicants who will be in day-to-day charge of the establishment/agency (dot 503kb) (opens new window)

Pre-interview form: Responsible individual and applicants who will not be in day-to-day charge of the establishment/agency (pdf 50kb) (opens new window)
Pre-interview form: Responsible individual and applicants who will not be in day-to-day charge of the establishment/agency (dot 495kb) (opens new window)

Applicant pre-registration self-assessment and assessor record - Acute (pdf 548kb) (opens new window)
Applicant pre-registration self-assessment and assessor record - Acute (doc 1647kb) (opens new window)

Applicant pre-registration self-assessment and assessor record - Core standards (pdf 408kb) (opens new window)
Applicant pre-registration self-assessment and assessor record - Core standards (doc 1193kb) (opens new window)

Applicant pre-registration self-assessment and assessor record - Dialysis (pdf 70kb) (opens new window)
Applicant pre-registration self-assessment and assessor record - Dialysis (doc 311kb) (opens new window)

Applicant pre-registration self-assessment and assessor record - Hospices (pdf 199kb) (opens new window)
Applicant pre-registration self-assessment and assessor record - Hospices (doc 983kb) (opens new window)

Applicant pre-registration self-assessment and assessor record - Hyperbaric oxygen treatment in type 1, 2 and 3 (pdf 95kb)
Applicant pre-registration self-assessment and assessor record - Hyperbaric oxygen treatment in type 1, 2 and 3 (doc 770kb)

Applicant pre-registration self-assessment and assessor record - In vitro fertilisation (pdf 97kb) (opens new window)
Applicant pre-registration self-assessment and assessor record - In vitro fertilisation (doc 808kb) (opens new window)

Applicant pre-registration self-assessment and assessor record - Lasers and intense pulsed lights (pdf 86kb) (opens new window)
Applicant pre-registration self-assessment and assessor record - Lasers and intense pulsed lights (doc 748kb) (opens new window)

Applicant pre-registration self-assessment and assessor record - Mental health (pdf 247kb) (opens new window)
Applicant pre-registration self-assessment and assessor record - Mental health (doc 1500kb) (opens new window)

Applicant pre-registration self-assessment and assessor record - Private doctors, independent clinics and independent medical agencies (pdf 130kb) (opens new window)
Applicant pre-registration self-assessment and assessor record - Private doctors, independent clinics and independent medical agencies (doc 733kb) (opens new window)

Applicant pre-registration self-assessment and assessor record - Termination of pregnancy (pdf 81kb) (opens new window)
Applicant pre-registration self-assessment and assessor record - Termination of pregnancy (doc 750kb) (opens new window)

EF2 Checklist for demonstration of building operational status (pdf 76kb) (opens new window)
EF2 Checklist for demonstration of building operational status (doc 117kb) (opens new window)

EF1 Checklist for detail of drawings plans and specifications (pdf 60kb) (opens new window)
EF1 Checklist for detail of drawings plans and specifications (doc 110kb) (opens new window)

Declaration of compliance and operational status (pdf 23kb) (opens new window)
Declaration of compliance and operational status (doc 26kb) (opens new window)

Hub and Spoke eligibility criteria assessment proforma (pdf 54kb) (opens new window)
Hub and Spoke eligibility criteria assessment proforma (doc 420kb) (opens new window)

Application - For independent sector places wishing to seek approval to perform abortions under the abortion act 1967 (pdf 34kb) (opens new window)
Application - For independent sector places wishing to seek approval to perform abortions under the abortion act 1967 (doc 41kb) (opens new window)

Applying as a manager

If you are applying to register as a new manager or a change of manager, you will need to complete Form R1A.

Form R1A: Application for registration: Registered manager (pdf 65kb) (opens new window)
Form R1A: Application for registration: Registered manager (doc 126kb) (opens new window)

Variation forms

Form V1: Application for variation or removal of conditions of registration (pdf 102kb) (opens new window)
Form V1: Application for variation or removal of conditions of registration (doc 84kb) (opens new window)

Cancellation

Form C1: Application for voluntary cancellation of registration: Service provider (pdf 48kb) (opens new window)
Form C1: Application for voluntary cancellation of registration: Service provider (doc 51kb) (opens new window)

Form C2: Application for voluntary cancellation of registration: Manager (pdf 46kb) (opens new window)
Form C2: Application for voluntary cancellation of registration: Manager (doc 48kb) (opens new window)

Responsible individual - guidance on their role and what to do if they change

When there is a change of responsible individual in an establishment registered with the Healthcare Commission, you are required to notify us in writing. Please use the form below, which sets out the information that we need and email, post or fax it to us. We have also provided guidance which explains the role of the responsible individual in further depth, and the legal requirements to be fulfilled if they change.

Form for when the responsible individual changes (pdf 60kb) (opens new window)
Form for when the responsible individual changes (doc 68kb) (opens new window)

Read guidance on the role of the responsible individual (pdf 35kb) (opens new window)

Read frequently asked questions about the role of the responsible individual (pdf 22kb) (opens new window)