Eligibility
No information is required, please proceed to the next page.
Your personal details
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Employment status at the time of self-isolation
If you are both employed and self-employed, select the option where you will lose most income.
Sorry, you are not entitled to a Test & Trace Support Payment. Please do not continue with the form, as you will not be able to submit it when reaching the end of the form.
If you have more than one job, enter the role where you will lose most income.
You cannot continue with this application if you don’t give us consent to contact your employer.
This can be a copy or photo of your most recent accounts, self-assessment return or business bank account statement no more than 2 months old.
No information is required, please proceed to the next page.
Benefit details
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Personal details of the child who has been told to self-isolate
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Sorry, you do not qualify for this payment.
No information is required, please proceed to the next page.
Supporting evidence
You must provide one of the following:
This is for parents and guardians of children or young people who have received a notification directly from NHS Test and Trace telling them to self-isolate.
This is for parents and guardians of children or young people who have been told to self-isolate by their education or childcare setting because they have been identified as a close contact of someone who has tested positive.
This is for parents or guardians of young people aged 16-25 who have additional support needs and who have been notified to self-isolate by the NHS COVID-19 App.
Please note that we are required to check with child or young person’s education or childcare setting that the self-declared information you have provide about them is accurate.
Sorry, we cannot accept applications without at least one of the three/four pieces of supporting evidence listed above.
No information is required, please proceed to the next page.
Bank details
This must be no more than 2 months old and can be a photo of the bank statement showing the account holder’s name, account number and sort code. If you are entitled to a payment, we will pay it into this bank account.
If you are employed, it must also include proof of wages being paid in.
No information is required, please proceed to the next page.
Declaration
By submitting this form:
• I confirm I meet the criteria for a Test and Trace Support Payment under the main scheme or discretionary scheme.
• I confirm that the information I have provided is true and accurate.
• I have read the government guidance for the Test & Trace Support Payment scheme and confirm I meet the criteria.
• I am the parent or guardian of a child or young person in the same household and need to take time off work to care for them while they self-isolate
• I am employed and not able to work from home and will lose income as a result OR I am self-employed, my business cannot be carried out during the period that my child is self-isolating and I will lose income as a result of this.
No information is required, please proceed to the next page.
Before you submit this form please review your answers below.
If you need to change anything, use the 'previous' button on the bottom left to go back to a section.
Then submit the form by selecting the 'Submit button' at the bottom of this page
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