01MEDICAL VISITOR (VAF1G NOV 2008)MEDICAL VISITOR (VAF1G NOV 2008) This form is for use outside the UK only. This form is provided free of charge.READ THIS FIRST This form must be completed in English. You may use blue or black ink.Please follow the guidance notes carefully and complete all questions as indicated. If you run out of space, please use Part 9 Additional Information.The UK Border Agency may take a decision on your application based on the information contained here without interviewing you. Therefore please ensure you submit all relevant original documents (please see supporting documents guidance).It is better to explain why you do not have a document than to submit a false document. Your application will be automatically refused and you may be banned from coming to the UK for 10 years if you use a false document, lie or withhold relevant information. You may also be banned if you have breached immigration laws in the UK.What is the main purpose of your visit to the UK? How long do you intend to stay in the UK?Travel Dates On which date do you wish to travel to the UK? D DM MY Y Y Y D DM MY Y Y Y On which date will you leave the UK? YOU shOUld cOmPlETE This fOrm if YOU arE visiTing ThE UK TO rEcEivE PrivaTE mEdical TrEaTmEnT. If the main reason you are applying to come to the UK is as: a tourist or to visit friends you must complete VAF1A; a family visitor you must complete VAF1B; a business visitor you must complete VAF1C; a student visitor, you must complete VAF1D; an academic visitor, you must complete VAF1E; to get married or register for marriage/civil partnership, you must complete VAF1F; if you are a visitor in transit, you must complete VAF1H; a sports visitor, you must complete VAF1J; an entertainment visitor, you must complete VAF1K. If you are visiting the UK for any other reason then please complete VAF1A.1.1 given name(s) (as shown in your passport) 1.2 family name (as shown in your passport)1.3 Other names (including any other names you are known by and/or any other names that you have been known by)Part 1about You read guidance, Part 11.4 sex Put a cross (x) in the relevant box Male Female1.5 marital status? Put a cross (x) in the relevant box Single Married/ Civil Partner Unmarried Partner Divorced/Dissolved Partnership Separated Widowed/Surviving Civil Partner 1.7 Place of Birth1.6 date of Birth D DM MY Y Y Y 1.10 do you hold, or have you ever held, any other nationality or nationalities? Put a cross (x) in the relevant boxIf Yes please provide details Yes No 1.8 country of Birth 1.9 nationality 02MEDICAL VISITOR (VAF1G NOV 2008)Yes No If Yes go to Part 32.1 current passport or travel document number 2.2 Place of issue2.3 issuing authority 2.4 date of issue 2.5 date of Expiry 2.6 is this your first passport? Put a cross (x) in the relevant box2.7 Please give details of any previous passports, covering the last 10 years, including where these passports are now.D DM MY Y Y Y D DM MY Y Y Y Part 2Passport information read guidance, Part 2Part 3Your contact details read guidance, Part 3Enter details of the passport or travel document that you will use to travel to the UK.3.1 Your full residential address and postal code 3.3 home (landline) telephone number3.2 how long have you lived at this address? 3.4 Your mobile telephone number3.5 Email address 3.6 contact details if different from those given in question 3.14.4 fathers place and country of birth D DM MY Y Y Y 4.3 fathers date of birth Part 4Your family read guidance, Part 44.1 fathers given name(s) 4.2 fathers family name 4.6 mothers given name(s) 4.5 fathers nationality/nationalities 4.8 mothers date of birthD DM MY Y Y Y 4.9 mothers nationality/nationalities 4.10 mothers place and country of birth4.7 mothers family name D DM MY Y Y Y 4.11 full name of spouse/partner (If single go to 4.16) 4.12 spouse/partners nationality/nationalities4.13 spouse/partners date of birth 03MEDICAL VISITOR (VAF1G NOV 2008)Yes No Yes No Yes No Yes If Yes go to 4.21 No If No go to Part 5. Yes No If No, please go to question 4.204.17 Please provide full details for each of your dependant children 4.14 does your spouse/partner currently live with you at the address given in Question 3.1? Put a cross (x) in the relevant box4.15 Will your spouse/partner be travelling with you? Put a cross (x) in the relevant box4.19 Please list any of your children who will be travelling with you to the UK?4.16 do you have