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Request for medical appointment drive

Please complete this form to request a drive to a medical appointment.

When you SUBMIT the form, you will get a receipt email from noreply@hugofox.com (see image below) which reproduces the information you have provided. This email comes from HugoFox, who provide our website platform. It does not mention Lymington Care Group but we will have received your request and one of our Duty Coordinators will contact you during office hours.

Lymington Care Group Request for medical appointment drive

Details of the transport request

Title *

First Name *

Surname *

Address *

Email Address *

Phone number to use in relation to this booking *

Please give date and time of your appointment *

Where is your appointment? *

Further information about your appointment (if relevant)

Please tick everything that applies

I have a Blue Badge
I will be using a Walker
I will be using Crutches
I will be using a Wheelchair
I will be accompanied
At least one of the people requiring transport (patient or companion) is aged under 18
I wish to bring my Service Dog
My appointment is expected to last for 2.5 hours or more

Emergency contact details on the day *

Mobile phone number to use on the day *

Other relevant information (eg assistance requirements but please note our drivers are not carers)

Are you happy for us to hold your data? *

I confirm that I have read and accept the Group's Privacy Notice

LCG privacy notice v1.2 Nov 25.pdf File Uploaded: 24 November 2025 2 MB