(Scroll down for FAQ in Maltese)
1.
What is the Schedule V (SCHV) document?
The SCHV was also
known as the yellow card as it was previously issued, as the name implies, as a
yellow card. It contains the information related to the patient and his/her
entitlement for free medication so that this document can be presented to the pharmacy
chosen by the patient to collect the required free medication.
2.
What should I do when my SCHV expires and how do I apply for a new
SCHV document?
The Government Formulary list determines the
prescriber criteria per item/medicinal. In general for most conditions new
applications must be issued by a Consultant.
However, health centre doctors can apply for Hypertension treatment as well as Genetic Dyslipidaemia (cholesterol) treatment
as per the Government formulary list. Private doctors who are specialists in
family medicine (as per Specialist Medical Doctor register) can only apply for
renewal of such treatment.
Your family doctor
will issue a referral ticket for an appointment with your caring Consultant.
The Consultant will then fill in an application for a new SCHV document to be
issued.
3. What should I do when the permit
expires?
Your GP will fill in a referral ticket to make an appointment with your
Consultant.
If your treatment is still necessary, your consultant
will sign at the bottom of the permit (if it is an old format) or else sign
next to the item with the permit to be renewed. Permits which used to be issued
on a white sheet are now included in the SCHV document along with the expiry date of the item,
4.
My Consultant added treatment to my current valid SCHV document in ink. Is this
enough to collect the new treatment?
A new SCHV document
needs to be issued with your newly added treatment. The SCHV document needs to
be sent to our office for further processing. The newly added medicine will
only be approved if it corresponds to the Schedule V condition of your original
application.
5.
I already have a SCHV document. What should I do if I need treatment for
another condition?
If you are diagnosed
with a new condition, your consultant will need to apply for a new SCHV. With
the previous system a SCHV document was issued for each condition. Now one SCHV
document is issued covering all the treatment needed to manage your condition.
6.
My SCHV Document is still valid, but it is full. Will I need to apply for a new
Yellow Document?
No. Your pharmacist
at the POYC or Government Pharmacy will attach a Continuation sheet to your
full SCHV Document. The Continuation sheet is not valid without the original SCHV
Document.
7.
What should I do with the SCHV Document/Permit Application?
The Schedule V
application can be sent directly to the Medicines Approval Section (MAS) in Gwardamangia by post or can be brought personally to our offices
8.00 a.m. -1.00 p.m. After hours it can be posted in the MAS letter
box which is affixed to the door of MAS office. The
application can also be posted in the letterbox at Mater Dei Hospital (MDH)
which can be found on the first floor near the billing section. The same
applies for the SCHV Document containing treatments which were added in ink, or
for any requests for the renewal of a signed permits.
Do not to take the
application directly to the pharmacy.
8.
I want to come personally to your office, what documents do I need to have with
me?
It is important to
bring the following items with you:
Your ID card and
Patient’s ID card (if you are coming on behalf of another person)
Old Yellow Document (if
you have one)
New application
signed by consultant.
Parents of patients
under 18 years of age are to bring their ID card.
Make sure to check
that the application forms are duly signed by applying Consultant.
9.
In case of being a foreign patient the following is required:
a. If you are working in Malta and paying N.I.
Contributions, please bring with your last
month’s pay slip. If you are
self-employed you are requested to present the most recent (not older than 6
months) receipt of N.I. contributions. A copy of
the birth certificate should also be attached in the case of an application for
the payer’s children
b. If you are married to a Maltese citizen,
please bring a photocopy of your spouse’s I.D. Card and a photocopy of the
marriage certificate.
c. If you are in receipt of a Maltese state
pension, you are requested to present the notice of pension payment (not older
than 6 months) issued by Social Security Department.
d. If you are an EU citizen residing in Malta
on a permanent basis, you are requested to present a Certificate of Entitlement
issued by the Entitlement Unit within the Ministry for Energy and Health, as
well as proof of identity.
NOTE that the
Entitlement Unit may only issue a Certificate of Entitlement upon presentation
of any of the following forms: E106, E109 and E121 or form S1. These forms are
issued by the competent authorities of your country of origin, if you are in
receipt of a state pension from that country or you are working in Malta and
paying social contributions in your country of origin.
e. If patients have a refugee status a SCHV is
issued till the validity of their refugee card. Patients who have subsidiary
protection or are asylum seekers are not entitled for the SCHV document.
However, they are still entitled for free medications from the health centres
in case of protocol regulated items, the MAS permits will be issued just the
same. Present a copy of the certificate showing status and
expiry date.
f. If you (or your dependents) are an EU/EAA national and
have permanent residence status, kindly provide a copy of your ID (Residence)
card.
If you do not yet have a Maltese Residence Permit (‘A’ number) you
should apply at Identity Malta. In the interim a copy of your passport or EU
foreign ID card should be attached to the application
10. Who can benefit from the POYC Scheme?
The POYC Scheme is
open only to those patients who are entitled to benefit from the Government’s
free pharmaceutical service in terms of Government’s policy or legislation
regulating the entitlement for free pharmaceutical services, That is all
patients who have been issued either a SCHV
document or are Pink card beneficiaries. Patients must register with a
pharmacy of their own choice to become eligible and start benefiting from the
Scheme.
11. How can
patients register with the POYC Scheme?
To register with the
POYC Scheme, patients must observe the following steps:
a. Patients must choose a pharmacy from that
is participating in the POYC Scheme.
b. Inform the Pharmacist that she wishes to
register with the POYC Scheme.
c. Obtain the POYC Scheme Registration Form
from that Pharmacy
12. How do
patients fill-in the POYC Scheme Registration Form?
The POYC Scheme
Registration Form is divided into 3 Sections. Each Section must be duly
filled-in as follows:
a. Section 'A' must be filled-in by the
patient. Each patient must have one Registration Form.
b. Section 'B' must be filled-in by the
managing pharmacist of the particular pharmacy.
c. Section 'C' must be filled-in by the
medical practitioner / family doctor, and this Section, must reflect the
patient's pharmaceutical entitlement according to the patient's valid
entitlement documents.
13. Which documents
must be submitted with the POYC Scheme ‘Registration Form’?
After the
Registration Form is duly filled-in, the patient must also attach photocopies
of the following documents:
a. The Entitlement Documents [SCHV, Schedule
II – Pink]. Please, make sure that the Documents are valid and carry the rubber
stamp of the medical consultant.
b. The special medicine entitlement permit [where
applicable] together with the MDH 145, SLH 145, DH 75 “To Whom It May Concern”
note which lists the medications that accompanies either the Pink Card or a SCHV
document with a “treatment as prescribed” clause for conditions such as:
Malignant Disease, Psychiatric condition and Psoriasis.
c. Copy of the patient’s ID Card.
14. What
should patients do with the Registration Form once it has been filled-in?
Once the
Registration Form is completed and the necessary photocopies made and attached,
it must be either returned together with the supporting documents to the
Managing Pharmacist of the particular local pharmacy or posted to the POYC
Unit, or personally delivered to the POYC Unit.
15. What happens if during processing of applications there are missing
documents?
In
the event that, upon receipt at POYC Unit, any of the above requested documents
are missing, the POYC Unit would return the
Registration Form to the patient together with a letter indicating that information is missing / what documents are still
required.
NOTE: The POYC Unit
will not be in a position to process the Registration Form unless all the required
information is available.
16. When will
it be possible for patients to collect the medicines/pharmaceuticals from the local
Pharmacy?
To collect the
medicines you must register with POYC. If you have not yet registered with POYC
it is not possible to collect any medicines/pharmaceuticals yet.
Patients will be
able to collect their medicines/pharmaceuticals from their chosen pharmacy on
the same day as long as the pharmacy has the item in stock. Speak to your
pharmacist straight away so that an order can be placed for your
medicines/pharmaceuticals.
NOTE:
a. Patients will only be able to collect their
medicines/pharmaceuticals from the chosen pharmacy
17. Do I still need a scheme card and how does the
pharmacist dispense?
The POYC Unit is no longer issuing or replacing
membership cards. The pharmacist scans the QR code printed at the top of the SCHV
document which gives access to the system in order for them to dispense.
18. How often
will patients need to go to the local pharmacy to collect the
medicines/pharmaceuticals?
Patients are to
collect their medicines / pharmaceuticals from their local pharmacy every 56
days (2 months).
NOTE: Controlled
Drugs [GREEN prescriptions] are to dispensed every 28 days.
19. What do
patients need to take with them to collect their medicines / pharmaceuticals
from their local pharmacy?
To be able to
collect medicines / pharmaceuticals from their local pharmacy, patients need to
present the following documents/ permits to the pharmacist:
a. The ID card.
b. A valid prescription by a medical
practitioner.
c. Schedule V document (stating your
entitlement).
d. The relevant Permits.
NOTE: When
collecting Controlled Drugs, together with the above patients are also required
to present:
a. A valid GREEN prescription [which is valid
for only ONE month from issue date].
b. A valid Control Card duly filled-in by the
medical practitioner.
20. What do patients need to do when they have
a change in their treatment?
When patients have a
change in their treatment / medication they must immediately notify the
managing pharmacist of their local pharmacy. The pharmacist, then, will make
the necessary arrangements so that their entitlement will be adjusted
accordingly.
Changes in treatment
can include:
a. Change in present dose and / or medication.
b. Suspension and/ or replacement of present
treatment.
c. Introduction of new treatment /medication.
NOTE: Patients must
also:
Ensure that the additional medicines / pharmaceuticals
have been endorsed by a medical consultant.
Update their SCHV at the one stop shops and the pink forms at the social security.
The pharmacist can also
update the entitlement by accepting MDH 145, SLH 145, DH 75 “To Whom It May Concern” that
accompany yellow cards which have “treatment as
prescribed” for
conditions such as“Malignant
Disease”, Psychiatric conditions and Psoriasis as well as
forms accompanying pink cards.
21. Is it possible for patients
to CHANGE the pharmacy that they will be registered with?
A Change in pharmacy will only be accepted
when a new Registration Form is forwarded to the POYC Unit, with as listed here
below:
Section A – Patient.
Section B – Person of trust,
if applicable.
Section C – Pharmacist duly
filled-in.
NOTE:
The PHARMACY will no longer be receiving a new scheme card.
________________________________________________________________________________
Mistoqsijiet Frekwenti
(Kwalunkwe referenza għall-persuna tas-sess maskili għandha tiġi kkunsidrata wkoll bħala referenza għall-persuna tas-sess femminili.)
1. X’inhu d-dokument tal-ħames skeda?
Id-dokument tal-ħames skeda hu magħruf ukoll bħala l-kartuna s-safra minħabba li kienet tkun maħruġa fuq kartuna safra. Fiha l-informazzjoni relatata ma’ l-intitolament għall-mediċina b’xejn sabiex tkun tista’ tiġi ppreżentata lill-ispiżerija magħżula mill-pazjent b’hekk ikun jista’ jirċievi t-trattament mediku b’xejn meħtieġ. Ikklikkja hawn għal aktar informazzjoni.
2. X’irrid nagħmel meta tiskadili l-Kartuna s-Safra?
Il-Formularju tal-Gvern jiddetermina il-kriterji li bihom jiġu preskritti l-mediċini u mingħand liema specjalist. Parti kbira mill-applikazzjonijiet iridu jsiru minn konsulent. It-tabib tal-familja jagħmillek biljett ta’ riferiment sabiex isir appuntament mal-Konsulent tiegħek. Il-Konsulent wara jimlilek applikazzjoni biex tkun tista’ tinħariġlek Kartuna Safra ġdida. Iżda tobba taċ-Ċentri tas-Saħħa jistgħu japplikaw għall-kundizzjonijiet ta’ Pressjoni u Kolesterol għoli skond il-Formularju tal-Gvern. Tobba privati li huma speċjalisti fil-mediċina tal-familja jistgħu japplikaw għal tiġdid ta’ dokumenti għal dawn il-kundizzjonijiet biss.
3. X’irrid nagħmel meta jiskadili l-permess?
It-tabib tal-familja jagħmillek biljett ta’ riferiment sabiex isir appuntament mal-Konsulent tiegħek. Jekk jibqa’ jkollok bżonn it-trattament, il-Konsulent jiffirmalek fuq in-naħa t’ isfel tal-permess skadut biex ikun jista’ jiġi mġedded. Il-permessi kienu jinħarġu fuq karta bajda iżda issa jiffurmaw parti mill-lista tal-Karta s-Safra stess u tinkludi d-data ta’ meta jiskadi l-permess.
4. Il-Konsulent tiegħi żiedli xi mediċini bl-inka fuq il-kartuna s-safra valida tiegħi. Dan biżżejjed biex nieħu t-trattament il-ġdid?
Hemm bżonn li tinħareġ Kartuna Safra ġdida li tinkludi t-trattament il-ġdid fuqha. Il-Kartuna s-Safra trid tintbagħat l-uffiċċju tal-POYC sabiex tiġi pproċessata. It-trattament il-ġdid jiġi approvat biss jekk dan jaqa’ taħt il-kundizzjoni oriġinali li fuqha nħarġitlek il-Kartuna s-Safra.
5. Jien diġa għandi Kartuna Safra valida. X’irrid nagħmel jekk ikolli bżonn trattament ġdid għall-kundizzjoni oħra?
Jekk tinstablek xi kundizzjoni oħra, il-Konsulent tiegħek irid jerġa’ japplikalek għall-Kartuna Safra oħra. Inti jista’ jkollok Kartuna Safra waħda (għal-kundizzjonijiet kollha li iddijanjostikata minnhom) bit-trattament kollu mniżżel, jew inkella Kartuna Safra għal kull kundizzjoni li tbati minnha. Madankollu, ma jistax ikollok iktar minn Kartuna Safra waħda għall-istess kundizzjoni; jew l-istess trattament imniżżel fuq Kartun differenti.
6. Il-Kartuna s-Safra tiegħi mtliet, imma għadha valida. Hemm bżonn japplikawli għal Kartuna Safra ġdida?
Le m’hemmx bżonn. L-ispiżjar tiegħek tal-POYC jew ta’ l-ispiżerija tal-Gvern jista’ jżidlek ‘Continuation Document’ mal-kartuna s-Safra tiegħek. Madankollu, il-‘Continuation Document’ mhiex valida jekk ma jkollix il-Kartuna s-Safra oriġinali mwaħħla magħha.
7. X’għandi nagħmel bl-applikazzjoni l-ġdida tal-Kartuna s-Safra/Permess?
L–applikazzjoni flimkien mal-Kartuna s-Safra l-antika, jew il-Kartuna s-Safra bit-trattament miżjud b'linka jew il-permess tista’: Tħallihom l-ispiżerija ta’ Mater Dei, jew tibgħathom bil-posta lill-‘Medicines Approval Section’, jew iġġibhom personalment l-uffiċċju tal-POYC u timpustahom fil-kaxxa postali tal-MAS li tinsab mal-bieb tal-uffiċċju, jew tiġu fil-ħinjiet tal-ftuħ tal-‘Customer Care’ u tistennihom biex jiġu pproċessati mill-istaff tal-MAS. Ġentilment int mitlub biex ma tieħux l-applikazzjoni l-ispiżerija.
8. Nixtieq niġi personalment l-uffiċċju tagħkom. X’dokumenti hemm bżonn li jkolli biex ninqeda?
Huwa importanti ħafna li jkollok miegħek dawn l-affarijiet:
Il-karta tal-identità tiegħek u tal-pazjent (jekk ġej f’isem ħaddieħor)
Il-Kartuna s-Safra l-antika
L-applikazzjoni l-ġdida ffirmata mill-konsulent
Kun żgur li tiċċekja li l-applikazzjonijiet huma ffirmati kif suppost mill-konsulent.
9. Fil-każ li int pazjent ta' nazzjonalita' barranija int mitlub issegwi dan li ġej:
a. Jekk inti taħdem f'Malta u tħallas il-kontribuzzjonijiet tal-N.I., jekk jogħġbok ġġib miegħek kopja ta' l-aħħar paga. Jekk inti qed taħdem għal rasek inti mitlub li tippreżenta l-iktar irċevuti reċenti (mhux aktar minn 6 xhur) ta' Kontribuzzjonijiet tal-N.I.
b. Jekk inti miżżewweġ lil ċittadin/a Malti/ja, jekk jogħġbok ġġib fotokopja ta I.D. Kard ta' żewġek/martek u fotokopja taċ-ċertifikat taż-żwieġ.
c. Jekk inti qed tirċievi pensjoni statali Maltija, inti mitlub li tippreżenta l-avviż ta' ħlas tal-pensjoni (mhux aktar minn 6 xhur) maħruġa mid-Dipartiment tas-Sigurtà Soċjali.
d. Jekk inti ċittadin tal-UE residenti f'Malta fuq bażi permanenti, inti mitlub li tippreżenta Ċertifikat ta' Intitolament maħruġ mill-Entitlement Unit fi ħdan il-Ministeru tas-Saħħa, kif ukoll prova ta' identità. Jekk jogħġbok innota li l-Entitlement Unit jista joħroġ biss Ċertifikat ta' Intitolament mal-preżentazzjoni ta' kwalunkwe waħda mill-forom li ġejjin: E106, E109 u E121 jew formola S1. Dawn il-formoli huma maħruġa mill-awtoritajiet kompetenti tal-pajjiż tal-oriġini tiegħek, jekk inti tirċievi pensjoni statali minn dak il-pajjiż jew jekk inti taħdem f'Malta u tħallas il-kontribuzzjonijiet soċjali fil-pajjiż tal-oriġini tiegħek.
e. Jekk pazjenti għandhom status ta’ Refuġjat, il-Karta s-Safra tinħareġ sad-data tal- validità tal-karta tar-refuġjati. Pazjenti bi protezzjoni sussidjarja jew li qed ifittxu l-ażil m’humiex intitolati għall-Karta s-Safra. Madankollu huma ntitolati xorta waħda għal mediċini bla ħlas li jistgħu jinġabru miċ-ċentri tas-saħħa. Permessi jinħarġu xorta waħda.
f. Jekk inti jew dawk illi jiddependu minnek huma nazzjonalità EAA u għandhom status ta’ residenza permanenti, ipprovdi kopja tal-karta ta’ l-identità.
Jekk inti m’għanekx permess ta’ residenza bin-numru jispiċċa “A” għandek tapplika għand l-Identity Malta. Fil-frattemp kopja tal-passaport jew ID Kard tal-pajjiż nazzjonali tiegħek ikun suffiċjenti biex tinħareg Karta Safra temporanja.
10. Min jista’ jibbenefika mill-iskema tal-POYC?
L-iskema tal-POYC hija miftuħa biss għal dawk il-pazjenti li huma ntitolati għall- mediċini b’xejn skond il-liġi. Dawk kollha li għandhom Karta Safra jew Karta Roża huma ntitolati. Il-pazjenti għandhom jirreġistraw għall-ispizerija tal-għażla tagħhom biex jibdew jibbenefikaw mill-iskema.
11. Kif nista’ nirreġistra għall-iskema?
Biex tirreġistra għall-iskema tal-POYC pazjenti għandhom isegwu il-passi li jmiss.
a. Pazjenti għandhom jagħżlu spiżerija mill-lista ta’ l-ispiżeriji li huma msieħba fl-iskema.
b. Jinfurmaw lill-ispiżerija illi jixtiequ jibdew jiġbru l-mediċina minn dik l-ispiżerija.
c. Jiġbru il-formula ta’ reġistrazzjoni għall- POYC minn dik l-ispiżerija
12. Kif timtela l-formula ta’ reġistrazzjoni għall-ispiżerija tal-għażla tiegħi?
Il–formula maqsuma fi tlieta:
a. Sezzjoni 'A' timtela mill-pazjent, formula waħda ġdida għal kull pazjent
b. Sezzjoni 'B' timtela mill-ispiżjar.
c. Sezzjoni 'C' timtela mit-tabib biex tirrifletti għalxiex inhu ntitolat l-pazjent skond id-dokumenti rilevanti (Karta Safra jew Roża).
13. Liema dokumenti għandhom jigu mibgħuta mal formula ta’ registrazzjoni?
Wara li timtela l-formula l-pazjent irid jehmeż fotokopji tad-dokumenti kif imiss:
a. Il-Karta s-Safra jew Roża validi.
b. Permessi.
c. MDH 145, SLH 145, DH 75 “To Whom It May Concern” li hija nota li fiha hemm lista ta’ liema mediċina jakkumpanjaw il-Karta s-Safra jew Roża li jkun fiha klawżola “treatment as prescribed” - jiġifieri trattament kif preskritt.
Din il-klawżola ġeneralement tkun għal kundizzjonijiet bħal: Kundizzjoni Malignant, Kundizzjonijiet Psikjatrici u Psoriasis.
14. X’għandi nagħmel il-formula tar-registrazzjoni la darba timtela?
Trid tiġi rritornata flimkien mad-dokumenti meħtieġa fl-ispiżerija tal-għażla tiegħek jew timpustaha lill-uffiċċju tal-POYC.
15.X’jiġri jekk fl-iproċessar tal-applikazzjoni jkun hemm dokumenti nieqsa?
Il-formula tintbgħat lura lill-pazjent flimkien ma’ ittra biex tindika dak li hemm bżonn.
L-uffiċċju tal-POYC ma tkunx f’posizzjoni li tirreġistra mal-ispiżerija tal-għażla tiegħek jekk xi informazzjoni tkun nieqsa.
16. Meta jkun possibli li niġbor il-mediċini mill-ispiżerija tal-għażla tiegħi?
Biex tiġbor il-mediċina trid tirreġistra għall-ewwel darba bħala pazjent mal-ispiżerija tal-għażla tieghek.
Sakemm ikun hemm il-mediċini stokkjati fl-ispiżerija l-pazjenti jkunu jistgħu jiġbru l- mediċina dakinhar stess li jkollhom id-dokument f’idejhom. Fil-każ li d-dokument trid tirċievih bil-posta tista’ tmur l-għada anki mingħajr id-dokumenti f’idejk. Kellem lill-ispiżjar sabiex ikun jista’ jordnalek il-mediċini tiegħek.
INNOTA: Pazjenti jistgħu jmorru biss f’dik l-ispiżerija rreġistrata mhux kwalunkwe spiżerija.
17. Hemm bżonn kard ta’ sħubija u kif jopera l- ispiżjar?
Le, POYC ma baqatx toħroġ il-Kard ta Sħubija. L-ispiżjara qed joperaw bil- kodiċi QR illi tidher fin-naħa ta’ fuq tad-dokument illi jagħti access għas sistema biex huma jkunu jistghu jamministraw il mediċina.
18. Kemm iridu jmorru spiss biex jiġbru il-mediċini il-pazjenti?
Pazjenti jridu jiġbru il-medicini kull xahrejn, (56 il-ġurnata).
INNOTA: Mediċini tar-riċetta ħadra li huma kkontrollati jitqassmu kull 28 il-ġurnata.
NOTE: Controlled Drugs [GREEN prescriptions] are to be dispensed every 28 days
19. X’irrid nieħu miegħi l-ispiżerija biex niġbor il-mediċina?
Biex ikunu jistgħu jiġbru il-mediċini jridu jieħdu magħhom id-dokumenti li jmiss.
a. ID Kard.
b. Riċetta valida
c. Dokument tal-ħames skeda (Schedule V)
INNOTA: Meta tiġbor il-mediċini kkontrollati trid tippreżenta wkoll:
a. Riċetta ħadra valida (li hija valida biss għal xahar minn meta tkun inħarġet)
b. Dokument tal-mediċini narkotiċi (Control Card)
20. X’irrid nagħmel meta jkolli bidla fit-trattament?
Meta pazjenti jkollhom xi tibdil fit-trattament għandhom jinfurmaw lill-ispizjar tagħhom li jkun jista’ jirranġa l-intitolament tagħhom minn fuq is-sistema.
Tibdil jista’ jkun kif gej:
Tibdil fid-doża.
Twaqqif ta’ xi mediċini.
Nota:
It-tibdil irid ikun sar minn konsulent li jista’ jagħmel dan it-tibdil.
Id-dokumenti roża jew sofor iridu jkunu aġġornati.
L-ispizjar jieħu ħsieb ukoll jagħmel tibdil fl-intitolament tal-pazjent billi jiġu ppreżentati l-formoli MDH 145, SLH 145, DH 75 “To Whom It May Concern” li jakkumpanjaw il- Karta s-Safra li jkollha fuqha “treatment as prescribed” għall-kundizzjonijiet bħal “Malignant Disease”, Kundizzjoijiet Psikjatriċi u Psoriasis, kif ukoll formoli u noti li jakkumpanjaw il-Karta r-Roża.
21. Huwa possibli li tinbidel l-ispiżerija tal-għażla tiegħi jekk diġà irreġistrajt?
Tibdil fl-ispiżerija tal-għażla tiegħek tkun possibbli biss jekk il-formola tar-Reġistrazzjoni li tasal fl-uffiċji tal-POYC tkun mimlija kif imniżżel hawn taħt:
Sezzjoni A – Bid-dettalji tal-pazjent.
Sezzjoni B – ‘Person of trust’ jekk hemm bżonn,
Sezzjoni C – Spiżjar.