This questionnaire is designed to capture the successes, failures and issues around accessing secondary NHS healthcare without charge for missionaries. It can be filled in by the mission partner themselves or by a church/organisation on their behalf. Please answer as many questions as possible.

Please note that on no account must names or medical details be entered onto this form in order to maintain the confidentiality of individuals concerned.

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* 1. Organisation/church name

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* 2. Type of NHS healthcare sought (e.g. outpatient care, admission to hospital after visit to A&E). Please DO NOT enter any names or medical details.

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* 3. Date on which the healthcare was sought

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* 4. Name of NHS Trust / hospital

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* 5. How long has the mission partner worked overseas?

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* 6. How long is the mission partner in the UK for at this time?

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* 7. What has been their pattern of returns to the UK since they have been living overseas? (e.g. every two years for two months / twice in eight years for four months each time etc.)

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* 8. Was the mission partner questioned by an Overseas Visitor Manager (or equivalent)?

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* 9. Was the outcome that the person was deemed ordinarily resident?

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* 10. If yes, what evidence was given and accepted for this?

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* 11. If no, what reasons were given?

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* 12. If you are happy for us to possibly contact you so we can ask you more about your experience and gain a better understanding of how people are being assessed, please enter your email address here:

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* 13. Any other comments

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