Booking - Mental Health - SSC Secure Transport

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SSC Secure Transport

Mental Health and Secure Transport Booking Form

Easily arrange safe, secure, and compassionate patient transport tailored to your needs. Fill out the form below to book our trusted services.

Prefer Not to Fill Out the Form Online?

No problem! If you’d rather not use the website form, you can download our contact form and send it to us by email.

Bookings are accepted only from hospitals, social services, and other authorised organisations. For all other enquiries, please email [email protected].

I confirm that I am booking on behalf of a hospital, social services, or other authorised organisation.

Your Name

Your Email

Telephone Number

Patient details

Service User’s Name

Gender

DOB

Patient NHS number:

MHA Status:

Conveyance details

Pick up date:

Pick up time:

Pick up address:

Pick up postcode:

Pick up ward:

Phone number:

Destination:

Destination postcode:

Destination ward:

Phone number:

Number of escorts required from SSC:

Vehicle Type:

Risk of absconding

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Risk of violence & aggression towards others

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Risk of allegations towards professionals

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Risk of Self-harm

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Risk of Suicide

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Risk of Self-neglect

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Verbal Abuse

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Damage to property

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Inappropriate sexual behaviour

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Risk of exploitation sexual, financial, others

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Drug/Alcohol misuse

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Physical health risks

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Arson or fire setting risk

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Social media related risk

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Risk of noncompliance with medication

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Contraband

Yes - High Yes - Moderate Yes - Low No

Historic Risk (Y/N)

Yes No

Journey Type

How did you hear about us?

Google Promotional materials (e.g. flyers, pens, mousepads) Word of mouth / Recommendation Other (please specify)

Other (please specify)

Exclusions Acknowledgement

I confirm that I have read and understood the service exclusions listed above. I acknowledge that:

Stretchers can only hold a maximum of 120 kg.
Palliative patients requiring medical support or patients with complex medical needs requiring nursing care will not be transported unless a RGN is provided by the hospital.
Patients requiring oxygen administration will not be transported.
Only one patient can be transported at a time in each vehicle.
Vehicles cannot accommodate bariatric wheelchairs or mobility scooters.

By ticking this box, I accept these exclusions and understand that transport may not be provided if any of these conditions apply.

ETA: 2h. We will update you if different.
Note: We do not transfer bariatric patients. Any patients who require oxygen must be accompanied by a hospital nurse and carry their own oxygen.

Providing safe, secure, and compassionate patient transport you can trust.

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