An FP17DC and an FP17DCO is the treatment plan form given to a patient in England at the start of each course of treatment.
An FP17DC(w) and an FP17DCO(w) form is the treatment plan given to a patient in Wales at the start of each course of treatment.
Examples of the treatment plan forms are available on our website.
When to complete a treatment plan form
An FP17DC or an FP17DC(w) must be issued to all patientsfor all Band 2 and Band 3 courses of treatment.
An FP17DC or FP17DC(w) form must also be issued for Band 1 courses of treatment if:
- it includes private treatment such as a private hygienist appointment
- the patient requests a treatment plan
An FP17DCO or an FP17DCO(w) must be completed for all courses of orthodontic treatment.
Where to get treatment plan forms
In England, FP17DC and FP17DCO forms can be ordered from Primary Care Support England.
To request a FP17DC(w) and FP17DCO(w) form in Wales, email Shared Services Partnership at nwssp-primarycareservices@wales.nhs.uk
Practices can also use a form generated by their practice management software. This must be signed by the patient and include the same information as the treatment plan form.