Form

Appeal to the First-tier Tribunal (Primary Health Lists): Form T170

Use this form to appeal a medical, dental, pharmacy or optical performers list decision, or an application to the NHS commissioning board for national disqualification or to extend a suspension.

Documents

Application form: T170

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 hmctsforms@justice.gov.uk. Please tell us what format you need. It will help us if you say what assistive technology you use.

Details

Find out how to appeal to the Primary Health Lists Tribunal.

Find more court and tribunal forms by category.

Find out how HM Courts and Tribunals Service uses personal information you give when you fill in a form.

Updates to this page

Published 1 October 2014
Last updated 10 July 2018 + show all updates
  1. Added revised Form T170 that includes GDPR information.

  2. First published.

Sign up for emails or print this page