HS01JUNE 2015 EDITION
To apply please see the form inside www.healthystart.nhs.uk
Free milk fruit veg and
vitamins for you and your family
Has
yo
ur
hea
lth
pro
fess
ion
al s
ign
ed y
ou
r ap
plic
atio
n f
orm
an
d h
ave
you
ch
ecke
d y
ou
h
ave
com
ple
ted
all
the
bo
xes
that
ap
ply
to
yo
u (
see
‘Bef
ore
yo
u p
ut
you
r fo
rm in
th
e p
ost
’ on
pag
e 10
)?
Tear off en
velop
e here
Health
y Start Issuin
g U
nit
FREEPO
ST RR
TR-SY
AE-JK
CR
PO B
ox 1067
WA
RR
ING
TON
WA
55 1EG
2904155 Health
y Start app
lication
leaflet Pro
du
ced b
y William
s Lea for th
e Dep
artmen
t of H
ealth
M
ois
ten
stri
pTe
ar o
ff e
nvel
op
e h
ere
All about Healthy StartHealthy Start is here to help you give your family the very best start in life.
If you’re pregnant or have a young child under four you could get Healthy Start vouchers worth £3.10 a week for you and your child.
The vouchers can be spent on milk, plain fresh or frozen fruit and veg (fruit and veg with nothing else added) and infant formula milk at your local shops. Plus you’ll get coupons for free vitamins too.
And if your children enjoy eating healthy food when they’re young, their good eating habits will stay with them for a lifetime!
Contents What vouchers do I get? 1
What can I buy? 2
Do I qualify? 3
Who uses them? 4
A few Q & As 6
Who to contact 7
How do I claim? 8
Dos and don’ts 9
Handy checklist 10
PART APART B
If you
are 16 or o
ver, sign
and
date th
e form
you
rself. Ifyo
u are u
nd
er 16, ask a paren
t or carer to
sign
and
date
the fo
rm.
By sig
nin
g:
I declare th
at the in
form
ation
I have p
rovid
ed in
this
app
lication
form
is correct an
d co
mp
lete.
I have read
and
un
dersto
od
the d
os an
d d
on
’ts of H
ealthy
Start (describ
ed o
n p
age 9 o
f the H
ealthy Start leaflet).
I agree to
follo
w th
ese rules d
urin
g an
y perio
d I receive
Health
y Start vou
chers fo
r myself o
r my fam
ily.
I agree that the UK
Health D
epartments can share
information about m
e with other organisations to check
that the information I have given is correct and to stop
false claims (as described on page 9 under the heading
‘Data protection’).
Part B: H
ealth p
rofessio
nal’s statem
ent
Sig
natu
re____________________________________________
Nam
e________________________________________________
Date
_________________________________________________
No
w a
sk y
ou
r health
pro
fessio
nal (u
sually
yo
ur
mid
wife
or h
ealth
visito
r) to co
mp
lete
the
state
men
t belo
w. Y
ou
do
no
t need
to p
ay a
nyth
ing
to
have y
ou
r form
sign
ed
.
Please read th
is7I ce
rtify th
at
(nam
e o
f ap
plica
nt)
___________________________________
date
of b
irth (o
f ap
plica
nt)
has co
nsu
lted
me a
bo
ut h
er p
reg
nan
cy
The e
xp
ecte
d d
ate
of d
eliv
ery
is
(ple
ase
fill in fu
ll date
).
AN
D/O
R
I certify
that th
e in
form
atio
n (s)h
e h
as g
iven
inPart A
, qu
estio
n 5
ab
ou
t his/h
er ch
ildre
n is, to
the b
est o
f my k
no
wle
dg
e, co
rrect.
AN
D I co
nfirm
that I h
ave g
iven
him
/her
health
-rela
ted
ad
vice
.
This fo
rm ca
n b
e co
un
tersig
ned
by a
ny re
giste
red
mid
wife
, nu
rse o
r med
ical p
ractitio
ner.
DD
MM
YY
YY
DD
MM
YY
YY
Health
pro
fessio
nal’s sig
natu
re
________________________________________________________
Health
pro
fessio
nal’s n
am
e
________________________________________________________
Date
of sig
nin
g
Su
rgery
stam
p o
r wo
rk a
dd
ress
Surg
ery po
stcod
e
GM
C n
o./N
MC
pin
______________________________________(o
ptio
nal)
Ap
plica
tion
s for H
ealth
y S
tart v
ou
chers w
ill no
t be
acce
pte
d w
itho
ut a sig
natu
re (or letter) fro
m yo
ur
health
pro
fession
al.
DD
MM
YY
YY
Nam
e__________________________________________________________
Date
of b
irth ______________________________
Nam
e__________________________________________________________
Date
of b
irth ______________________________
Nam
e__________________________________________________________
Date
of b
irth ______________________________
You
r child
ren: Please g
ive details o
f any ch
ildren
(un
der 4) yo
u alread
y have (co
ntin
ue o
n an
oth
er sh
eet of p
aper if n
ecessary)5
Are yo
u p
regn
ant?
Yes
No
6
I understand that if I knowingly claim
support from H
ealthy Start that I am
not entitled to, this support may be stopped
and I will be liable to reim
burse the UK
Health D
epartments
the value of any vouchers and vitamin coupons I have
received and used.
1
• If you’re pregnant you get one voucher a week worth £3.10
• For each baby under the age of one, you get two vouchers a week worth a total of £6.20
• For each child aged over one and under four, your family gets one voucher a week worth £3.10
So what vouchers do I get?
And if you’re pregnant, or have a child under four, you’ll also get coupons for vitamins. Vitamin tablets for you; drops for your baby or child. Helping them to grow up strong and healthy.
A G
uid
e fo
r Fa
mili
es
Ap
plic
atio
n f
orm
fo
r H
ealt
hy
Star
t vo
uch
ers
Fill
in t
his
ap
plic
atio
n f
orm
cle
arly
in b
lack
ink,
in E
ng
lish
an
d in
CA
PITA
L le
tter
s
PART A
Tear
alo
ng
do
tted
lin
e
Lin
e 1
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Lin
e 2
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Tow
n__
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___
Co
un
ty__
____
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____
____
____
____
____
__ _______________________________________________re
bm
un e
no
hpeleT
ed
octsoP
HS0
1_V
4
Titl
e__
____
____
Surn
ame
____
____
____
____
____
____
____
____
___
Firs
t n
ame
____
____
____
____
____
____
____
____
____
____
____
____
Tick
all
the
bene
fits
you
are
get
ting
:
You
:Ple
ase
fill
in t
he
det
ails
of
the
per
son
wh
o is
ap
ply
ing
(th
is is
yo
u, i
f yo
u a
re p
reg
nan
t)1
Dat
e o
f b
irth
Nat
ion
al In
sura
nce
nu
mb
er
DD
MM
YY
YY
Inco
me
Sup
po
rt
Inco
me-
rela
ted
Em
plo
ymen
t an
d S
up
po
rt A
llow
ance
In
com
e-b
ased
Jo
bse
eker
’s A
llow
ance
Ch
ild T
ax C
red
it (
wit
h a
fam
ily in
com
e b
elo
w£1
6,19
0)
Wo
rkin
g T
ax C
red
it*
No
ne
of
thes
e b
enef
its
Inco
me
Sup
po
rt
Inco
me-
rela
ted
Em
plo
ymen
t an
d S
up
po
rt A
llow
ance
In
com
e-b
ased
Jo
bse
eker
’s A
llow
ance
Ch
ild T
ax C
red
it (
wit
h a
fam
ily in
com
e b
elo
w£1
6,19
0)
Wo
rkin
g T
ax C
red
it*
No
ne
of
thes
e b
enef
its
You
r ad
dre
ss a
nd
tel
eph
on
e n
um
ber
: Ple
ase
tell
us
wh
ere
you
live
an
d y
ou
r cu
rren
t te
lep
ho
ne
nu
mb
er2 Ti
tle
____
____
__Su
rnam
e__
____
____
____
____
____
____
____
____
_
Firs
t n
ame
____
____
____
____
____
____
____
____
____
____
____
____
Rel
atio
nsh
ip t
o a
pp
lican
t___
____
____
____
____
____
____
____
____
Tick
all
the
ben
efit
s h
e o
r sh
e is
get
tin
g:
You
r p
artn
er –
if t
hey
live
wit
h y
ou
: Th
is c
ou
ld b
e yo
ur
hu
sban
d, w
ife,
bo
yfri
end
or
gir
lfri
end
.3
Dat
e o
f b
irth
Nat
ion
al In
sura
nce
nu
mb
er
DD
MM
YY
YY
Titl
e__
____
____
Surn
ame
____
____
____
____
____
____
____
____
___
Firs
t n
ame
____
____
____
____
____
____
____
____
____
____
____
____
Rel
atio
nsh
ip t
o a
pp
lican
t__
____
____
____
____
____
____
____
____
You
r ca
rer
and
car
er’s
par
tner
: On
ly f
ill t
his
in if
yo
u a
re u
nd
er 1
8 (o
r u
nd
er 2
0 an
d in
fu
ll-ti
me
edu
cati
on
)an
d li
ve w
ith
a c
arer
– e
.g. a
par
ent
4
Dat
e o
f b
irth
Nat
ion
al In
sura
nce
nu
mb
er
DD
MM
YY
YY
Inco
me
Sup
po
rt
Inco
me-
rela
ted
Em
plo
ymen
t an
d S
up
po
rt A
llow
ance
In
com
e-b
ased
Jo
bse
eker
’s A
llow
ance
Ch
ild T
ax C
red
it (
wit
h a
fam
ily in
com
e b
elo
w£1
6,19
0)
Wo
rkin
g T
ax C
red
it*
No
ne
of
thes
e b
enef
its
Inco
me
Sup
po
rt
Inco
me-
rela
ted
Em
plo
ymen
t an
d S
up
po
rt A
llow
ance
In
com
e-b
ased
Jo
bse
eker
’s A
llow
ance
Ch
ild T
ax C
red
it (
wit
h a
fam
ily in
com
e b
elo
w£1
6,19
0)
Wo
rkin
g T
ax C
red
it*
No
ne
of
thes
e b
enef
its
Tick
all
the
ben
efit
s th
at y
ou
r ca
rer
and
yo
ur
care
r’s
par
tner
are
get
tin
g (
even
if y
ou
are
ap
ply
ing
bec
ause
yo
u a
re p
reg
nan
tan
d u
nd
er 1
8, a
s it
will
hel
p u
s se
e if
yo
u m
ay b
e ab
le t
o g
et v
ou
cher
s af
ter
you
r b
aby
is b
orn
):
I am
incl
ud
ed in
my
care
r’s/
care
r’s
par
tner
’s c
laim
fo
r:
Titl
e__
____
____
Surn
ame
____
____
____
____
____
____
____
____
___
Firs
t n
ame
____
____
____
____
____
____
____
____
____
____
____
____
Rel
atio
nsh
ip t
o a
pp
lican
t___
____
____
____
____
____
____
____
____
bYo
ur
care
r’s
par
tner
(if
ove
r 18
yea
rs o
ld a
nd
livi
ng
wit
h y
ou
)4
cC
om
ple
te if
yo
u a
re 1
8 o
r 19
yea
rs o
ld, i
n f
ull-
tim
e ed
uca
tio
n a
nd
pre
gn
ant
4
aYo
ur
care
r4
Dat
e o
f b
irth
Nat
ion
al In
sura
nce
nu
mb
er
DD
MM
YY
YY
Ple
ase
tu
rn o
ver
*If
you
or y
our
fam
ily r
ecei
ve W
orki
ng T
ax C
redi
t, y
ou d
o no
t qu
alif
y fo
r H
ealt
hy S
tart
unl
ess
you
are
pre
gnan
t an
d un
der
18.
Do
not
tick
thi
s bo
x if
you
r fa
mily
is g
etti
ng W
orki
ng T
ax C
redi
t ru
n-on
onl
y
. See
‘Do
I qua
lify?
’
V4
• liquid cow’s milk
• plain fresh or frozen fruit
• plain fresh or frozen vegetables
• infant formula milk
2
What can I buy with my vouchers?
You can use them at local shops and greengrocers as well as supermarkets. To find your nearest participating shops go to www.healthystart.nhs.uk or call the Healthy Start helpline on 0345 607 6823.
And don’t forget your vitamins. Make sure you ask your midwife or health visitor where you can exchange your coupons for vitamins for you and your child locally.
3
Do I qualify?You qualify for Healthy Start if you’re at least 10 weeks pregnant or have a child under four years old AND you or your family get…
• Income Support, or
• Income-based Jobseeker’s Allowance, or
• Income-related Employment and Support Allowance, or
• Child Tax Credit (but not Working Tax Credit unless your family is receiving Working Tax Credit run-on only*) AND an annual family income of £16,190 or less in 2015/16.
You also qualify if you are under 18 and pregnant, even if you don’t get any of the above benefits or tax credits.
We know that the benefits system is changing and that Universal Credit is being expanded to families. This means that, due to a change in circumstances, you may be assessed for entitlement to Universal Credit instead of the benefits you or your partner were claiming previously. Alternatively you may be new to the benefits system and may be assessed for entitlement to Universal Credit from the start of your claim. Whatever your circumstances, if you are claiming Universal Credit and are pregnant, or have a child under four years old, make sure you call the Healthy Start helpline on 0345 607 6823 or email [email protected] for information about any discretionary support that may be available.
* Working Tax Credit run-on is the Working Tax Credit you receive in the 4 weeks immediately after you have stopped working for 16 hours or more per week (single adults) or 24 hours a week (couples).
4
Who uses Healthy Start vouchers?
Sabrina & AleshaSabrina has a three-month-old baby girl called Alesha and is on Income Support as well as Child Tax Credit.
Each week, she gets vouchers worth £6.20 – that’s over £322 in vouchers by Alesha’s first birthday! Right now Sabrina is breastfeeding, so she is using the vouchers for milk, fruit and vegetables for herself until Alesha goes on to solid food. She gets her free vitamins from the local baby clinic – and knows that by taking them herself she’s helping Alesha too.
Angela & her unborn babyAngela is pregnant. She’s 17 years old and lives at home with her parents, who don’t claim any benefits.
She gets one Healthy Start voucher worth £3.10 every week – and she’ll keep on getting them until her baby is born. Angela also picks up free Healthy Start vitamins from her midwife, helping to make sure she and her unborn baby get everything they need.
5
So...To find out how Healthy Start could help you, why not talk to your midwife or health visitor when you get the chance? They’re always happy to offer help and advice about health, including healthy eating and breastfeeding. They’ll also be able to tell you about local support services such as Sure Start Children’s Centres and family centres for pregnant women and families with young children.
David & Ryan25-year-old David is a single dad with a three-year-old boy called Ryan. He’s not working and gets the highest rate of Child Tax Credit. David gets one £3.10 Healthy Start voucher each week for Ryan.
That’s £3.10 every week to spend on milk, fruit and vegetables and David picks up free vitamin drops for Ryan from the local children’s centre.
6
A few questions and answers
How long will it take to get my vouchers?Once we get your application form we’ll check that we’ve got all the information we need. If everything is there and you qualify, we’ll send your first vouchers within two weeks. If you don’t hear back from us within two weeks, call the Healthy Start helpline on 0345 607 6823.
How often do I get my vouchers?Once you’re on the scheme, we’ll send you Healthy Start vouchers every four weeks, and a vitamin coupon every eight weeks.
What happens if I don’t fill out the form properly?We’ll have to send it back to you – or if we’ve got your phone number, we might be able to sort it out that way. Either way it’ll delay your application, so double-check all your details!
Why do I need to put my National Insurance number on the form?It’s to check that you qualify for Healthy Start – if you’re over 16 and don’t put it on your form, we won’t be able to send you vouchers. So please make sure we have it!
I’m pregnant and under 18. Do I need to tell you about any benefits or tax credits that me or my family’s getting?
If you’re under 18 and applying for vouchers because you’re pregnant, not because you already have a child, then you don’t have to tell us about any benefits or tax credits you are getting. But it’s good if you DO tell us if you are getting them, otherwise your vouchers will stop coming as soon as the baby is born.
7
What do I do about the National Insurance number if I’m under 16?Leave the box blank. It won’t affect your application, but as soon as you get your number, call or write to us and tell us.
How do I claim qualifying benefits or tax credits?To claim tax credits, or add a new child to an existing claim, ring the Tax Credit Helpline on 0345 300 3900. To claim any of the other qualifying benefits, ring Jobcentre Plus on 0800 055 6688.
What do I do if my circumstances change once I’m getting vouchers?
Tell us – but make sure you tell the Tax Credit Helpline or your local Jobcentre Plus or benefits office too. If you move home, it’s vital that you tell them right away because we always send your vouchers to the address you use to claim benefits or tax credits. If you delay, your vouchers will keep going to your old address and we won’t be able to replace them.
Our contact detailsStill have some questions or want another copy of the application form? Call Healthy Start: 0345 607 6823 (9am–5pm Monday to Friday), textphone: 0845 601 7698
If you wish to order copies of this leaflet in bulk, call: 0300 123 1002, textphone: 0300 123 1003 or go online at www.orderline.dh.gov.uk
This leaflet is also available in alternative formats.Legal notice
• This leaflet gives general guidance and should not be treated as a complete and authoritative statement of law
• The text of this leaflet may be reproduced without formal permission or charge for personal or in-house use
© Crown copyright 20142902036 Produced by Williams Lea for the Department of Health
Benefits are changing. For more information on the new Universal Credit visit GOV.UK
8
How do I claim?
8
1. YouEnter your details here. Or, if you’re filling in this form for someone else who is pregnant, enter their details. They will then need to sign section 7 unless they’re under 16.
2. Your address and telephone number
Make sure that the address you give matches the address you use to claim benefits and tax credits if you get them.
If the address on your Child Tax Credit or benefit claim is out of date, tell the Tax Credit Helpline on 0345 300 3900 or your local Jobcentre Plus or benefit office as soon as possible. If the address you put on your application form is different to the one that you use for your benefits or tax credit claim, we will send the form back to you.
3. Your partner - if they live with youIf you have a partner who lives with you, tell us about them.
4. Your carer and carer’s partnerIf you’re under 20 and live with a parent or carer, please tell us about them, and any partner they have who lives with them.
If you’re 18 or 19 and in full-time education, you must confirm in section 4c if your carer or carer’s partner has named you as a dependant in their claim for any qualifying benefits or tax credits.
5. Your childrenGive the full names and dates of birth of every child that you’re claiming vouchers for. If you’re claiming for more than three children, put their full names and dates of birth on a separate piece of paper and attach it to your application form.
Part A is your section – please complete clearly in BLACK ink and refer to the hints and tips below
Part B is for a health professional – your midwife, health visitor, nurse or doctor
9
6. PregnancyTick the box to tell us whether the person named in section 1 is pregnant or not.
7. Signing the form The person named in section 1 should sign and date the form here, unless they’re under 16. If they are under 16, the parent or carer named in section 4 should sign and date the form.
IMPORTANT INFORMATION
Healthy Start vouchers are for the people who need them most. It’s breaking the law to give us details that you know aren’t true when applying for Healthy Start, or not to tell us if your circumstances change.
You could be prosecuted.
DATA PROTECTION
The information you give us will only be used by the UK Health Departments and their service providers. They may contact other organisations to check that the information is correct and to stop false claims.
From time to time we, or our researchers, may invite you to tell us how the scheme is working for you, to help us improve it.
Dos Do make sure you use your vouchers before their use-by date
Do use your vouchers fully as shops can’t give you change
Do let us know if your circumstances change – and tell the Tax Credit Helpline and Jobcentre Plus too
Don’ts Don’t use your vouchers for anything not listed in this booklet
Don’t give your vouchers away
1010
Please tick off the list below before you post your form:
� I’ve checked that I qualify for Healthy Start on page 3
� I’ve filled in my details in sections 1 and 2
� I’ve completed sections 3 and 4 with any details of my partner and/or parent/carer (as appropriate)
� The National Insurance numbers on the form are correct
� I’ve given the full names and dates of birth of all children I’m claiming for in section 5
� I’ve stated if I’m pregnant in section 6
� I’ve signed and dated section 7
� I got a health professional to complete Part B, including my expected date of delivery (if pregnant)
A handy checklist
Finished? Great. Now send us the form, using the freepost envelope at the back of this leaflet (you don’t need a stamp).
Lost your freepost envelope? Never mind, just find your own envelope and send your form to the address below – you still don’t need a stamp!
Healthy Start Issuing UnitFREEPOST RRTR-SYAE-JKCRPO Box 1067WarringtonWA55 1EG