Form

Restriction: consent or certificate (RXC)

Application form RXC: for a consent or certificate in respect of a restriction

Applies to England and Wales

Documents

Restriction: consent or certificate (RXC)

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Restriction: consent or certificate (RXC)

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 [email protected]. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

You should use this form where a restriction in the register requires a consent or a certificate to be provided.

Updates to this page

Published 26 July 2021
Last updated 19 August 2024 + show all updates
  1. We are making some amendments to our form RXC. The main changes to the form are in panels 3 and 5. Panels 1, 2 and 4 of the form have not been significantly changed. Panel 3 now includes revised options which make it easier for the person completing the form to tell us the basis on which they are able to provide a consent or certificate. We have also reworded the guidance notes for panel 3 with the aim of making the form flow better for those completing it. Panel 5 has been redesigned, and the person providing a certificate now has to select one of three options, Option A, Option B or Option C.

  2. The form has been amended as a result of feedback received.

  3. Added translation

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