Book Your Transport Online

Welcome to EMED Patient Care's online patient transport booking request form. If you've booked transport with us before and you’re registered with a GP in Nottinghamshire, you can now submit your transport request quickly and securely through this form.

What you’ll need to complete your booking request:

NHS Number and patient details (including GP name and address)
Date and time of the appointment
Appointment location (including ward, clinic, or department if needed)

Please do not proceed unless you have these details to hand.

Please note: This booking request form is for patients registered with a GP in Nottinghamshire only. If this is your first journey with EMED, you must call our booking teams to register your details before you can use this form.

All bookings are subject to eligibility criteria. If you're unsure about your eligibility or need assistance, please call our team on 0330 380 0570.

Before you begin, please make sure you read and agree to our privacy policy.

Privacy policy*

I have read and agree to the privacy policy

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Terms and Conditions

I have read and agree to the terms and conditions

Is this the patient's first time travelling with us?*

Yes

No

Is the patient's appointment within the next 7 days?*

Please note we can only accept bookings for appointments within the next 8 weeks

Yes

No

Is the patient travelling for an oncology or renal treatment/procedure?*

Yes

No

Does the patient have access to their own vehicle or access to family or friends that can help them travel to their appointment?*

Yes

No

Travel Requirements

For patient safety and to ensure the right level of care, please confirm if any of the following apply to this booking:

The patient requires medical gases during the journey (e.g. oxygen)
The patient needs to travel alone for medical reasons (e.g. infection risk, immunity concerns)
The patient must remain lying down for a medical reason during the journey
A bariatric vehicle is required (e.g. if the patient weighs over 120kg)
There are steps or stairs at the property that require lifting or carrying assistance
The patient is confined to their own wheelchair throughout the journey
The patient will experience significant side effects from treatment that make other transport unsafe
The patient suffers from mental health conditions (excluding Alzheimer's disease or dementia)

Do you require any of the above?*

Yes

No

Call Back

Due to the nature of the patient's requirements, we will need to contact you to discuss the booking further. Please provide your contact details below and we will be in touch...

Your name*

Title First Last

Patient's NHS number*

Phone number*

Please enter either a mobile number or landline so we can get in touch

Email address

Please select your preferred contact method*

Phone

Email

Are you booking on behalf of yourself or someone else?*

Myself

Someone else

Your name*

Relationship to the patient*

Patient Details

Please provide details of the patient who will be travelling with us.

Patient's NHS number*

Patient's name*

Title First Last

Patient's date of birth*

Patient's gender*

Disabilities*

Select all that apply

Patient's phone number*

Please enter either a mobile number or landline so we can get in touch

Patient's email address

Please select the patient's preferred contact method*

Phone

Email

Patient's home address*

Address Line 1 Address Line 2 City/Town County Post Code Country

Mobility Details

What is the patient's mobility?*

Please select from the following options that best describe your mobility

The patient can get in or out of a car unassisted

The patient requires a higher vehicle or walking aids

The patient can transfer from one wheelchair to another with the help of 1 person

The patient requires the assistance of 2 people in order to move

Does the patient suffer from dementia, mental health or communication issues?*

Yes

No

Does the patient require a medical escort?*

Yes

No

GP Practice Details

Please provide details of the patient's GP practice.

Has the patient's GP practice changed since they last travelled with us?*

Yes

No

Patient's GP practice name*

Patient's GP practice location*

City/Town County

Patient's new GP practice name*

Patient's new GP practice address*

Address Line 1 Address Line 2 City/Town County Post Code Country

Appointment and Journey Details

Please provide details of the patient's appointment and journey requirements.

Is this a recurring appointment?*

Yes

No

What type of appointment is the patient attending?*

Outpatient appointment

Hospital admission

Appointment date*

If this is for a recurring appointment, please select the date of your first appointment.

Appointment time*

:

Estimated return time*

:

From Address

Collection address*

Same as home address

Address Line 1 Address Line 2 City/Town County Post Code Country

To Address

Hospital or clinic name*

Department*

Hospital or clinic location*

City/Town County

Review your request

Please review your transport request below. If you have completed all fields correctly, please click next below to submit your request.

From Address
Collection address
	, Map It

None
Amputee
Angina
Anxiety
Arthritis
Asthma
Auditory Impairment
Autistic
Breathing Difficulties
C Diff
Cancer patient
Confusion
COPD
Dementia
Diabetic
DVT
Epilepsy
Heart Problems
History of falls
Incontinent
Lack of mental ability
Lack of mobility
Language Difficulties
Learning Difficulties
Learning Disability
Mental Health
Mental Illness
MRSA
Mta
Multiple Sclerosis
Musculoskeletal Disorders
Non-cognitive
Osteoporosis
Parkinsons
Renal Failure – regular dialysis
Sensory neuropathy
Short term memory loss
Speech impediment
Stroke
Tracheostomy
Visual Impairment

EMED Patient Care - Nottinghamshire Bookings

Book Your Transport Online

Travel Requirements

Call Back

Patient Details

Mobility Details

GP Practice Details

Appointment and Journey Details

From Address

To Address

Review your request