Form

Apply for trial leave or full transfer to another hospital for restricted patients

Complete this form when a restricted patient needs to be transferred to another secure hospital.

• From: HM Prison and Probation Service
• Published: 27 February 2011
• Last updated: 6 July 2021
  Show all updates

  1. 6 July 2021

     Added 'Summary of guidance on making applications for trial leave or transfer to another hospital'

  2. 23 February 2021

     Attachment update: Request full s19 transfer for restricted patients.

  3. 5 November 2020

     Add new forms: Request full transfer for restricted patients Request trial leave for restricted patients

  4. 2 August 2019

     updated email address for completed submissions

  5. 27 March 2019

     Updated instructions for sending completed forms

  6. 20 January 2017

     Updated form and guidance

  7. 27 February 2011

     First published.

Applies to England and Wales

Documents

Guidance for medical professionals dealing with restricted patient hospital transfers

MS Word Document, 175 KB

Request trial leave for restricted patients

MS Word Document, 77.5 KB

This file may not be suitable for users of assistive technology.

Request an accessible format

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email web.comments@justice.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Request Bulk Transfer for Restricted Patients

MS Word Document, 81.7 KB

This file may not be suitable for users of assistive technology.

Request an accessible format

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email web.comments@justice.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Hospital Transfer Downgrade

MS Word Document, 111 KB

This file may not be suitable for users of assistive technology.

Request an accessible format

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email web.comments@justice.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Hospital Transfer Upgrade

MS Word Document, 105 KB

This file may not be suitable for users of assistive technology.

Request an accessible format

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email web.comments@justice.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Hospital Level Transfer

MS Word Document, 109 KB

This file may not be suitable for users of assistive technology.

Request an accessible format

If you use assistive technology (such as a screen reader) and need a version of this document in a more accessible format, please email web.comments@justice.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

This form should be filled in by the clinician responsible for the restricted patient’s care.

Check the attached guidance if you need more information.

Email the completed document to: MHCSMailbox@justice.gov.uk