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Request for a Direct Payment Review

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Direct Payment Review

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use the Click on the numbered sections on the left hand side of the window or use the and options to move through the pages. DON'T use the Browser 'Back' button as you might lose information. image. and Click on the numbered sections on the left hand side of the window or use the and options to move through the pages. DON'T use the Browser 'Back' button as you might lose information. image. options to move through the pages.
DON'T use the Browser 'Back' button as you might lose information.

Protecting your information

When submitted, the data collected on this form will be treated confidentially and only used by Leicestershire County Council for the purpose of providing information, advice and support to meet your needs. To be able to do this, information may be shared with relevant NHS agencies and providers of carers' services to help reduce the number of times you are asked for the same information.
The information provided on this form will only be shared as allowed by current Data Protection Law.

The Form

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You DON'T need to answer every question, you need only complete what is relevant.
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