Our Compassionate Travel Grant is designed to provide funding for travel to medical appointments to as many patients as possible. Please be advised that the amount available, is up to a maximum of £100.00 as a one-off payment. If your patient is experiencing financial difficulties, they may find Macmillan's information and advice services on other grants and loans helpful: Other grants and loans.

This form must be completed by a member of your care team.

Please allow a 10 working day processing time, and up to two weeks for payment, should your application be approved.

Healthcare Professional Contact Details

First Name

Last Name

Job Title

NHS Trust

Contact Telephone Number

Please select here to state that you are a healthcare professional completing this form on behalf of a patient.

I confirm the above statement is true

Reason for Request

Patient Details

Patient Name

Patient Address

Patient's telephone number

Please state patient's email address, if known.

Date of Scan and/or Treatment(s)

Mode of Transport e.g. Plane, Train, Taxi

Requested Amount (up to Max £100.00 - one off payment)

Number of people travelling

Patient's bank details - Please note, without the patient's banking details we are unable to process the application.

Patient's Bank Name - TSB, Lloyds etc.

Sort Code

Account Number

Name as it appears on bank account

Contact Information