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Definition of a pre-existing medical condition
(What we need from you)

Please give details of the condition/symptoms; dates; GP's name, address and telephone number if you or your dependent child:

• Are currently taking any prescribed medication, or have taken prescribed medication in the last 12 months;
• Have consulted a GP or Consultant Physician/Consultant Surgeon during the last 12 months;
• Have received advice or treatment from a qualified practitioner or therapist i.e. Physiotherapist, Acupuncturist, Chiropractor, Homeopath, Osteopath, Chiropodist, Podiatrist or any other complementary medicine practitioner, during the last 12 months;
• Have attended a hospital or registered treatment centre during the last 12 months;
• Are awaiting any medical tests, investigations or treatment, or are awaiting the results of any medical tests or investigations, whether or not the condition has been diagnosed;
• Attend your GP, Consultant Physician/Consultant Surgeon or hospital for monitoring or check-ups;
• Have an illness, injury or condition that is permanent, or has ever previously recurred or that is likely to recur.

If you are not sure whether a fact needs to be declared you should tell us so that we can decide whether it is relevant or not.