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 — See all updates

Applies to England and Wales

Documents

Guidance for medical professionals dealing with restricted patient hospital transfers

MS Word Document, 222 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 [email protected]. Please tell us what format you need. It will help us if you say what assistive technology you use.

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 [email protected]. 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 [email protected]. 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, 226 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 [email protected]. 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, 221 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 [email protected]. 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, 224 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 [email protected]. 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: [email protected]

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.