Hearing questionnaire 1 - To the patient's representative and to the responsible authority

Published date21 March 2018
Subject MatterMental Health Tribunal forms and guidance

The First-tier Tribunal

(Health, Education and Social Care Chamber)

Mental Health

To the Responsible Authority: Please complete BOTH parts of this HQ1 Form.

To the Patient’s Representative: Please complete case details box below and HQ1 LISTING (overleaf).

Case Number: / /


Responsible Authority:

Person Responsible for filling the HQ1 form – Please tick the appropriate box

Patient Solicitor

Mental Health Administrator

Nearest Relative Solicitor

By law, the Responsible Authority must send to the tribunal all the documents specified in the latest Practice Direction[1] from the Senior President of Tribunals - (“the Practice Direction”) - so that they are received as soon as practicable and in any event within 3 weeks after the Responsible Authority made the reference or received a copy of the application or reference.[2]

The Responsible Authority must ensure that statements and reports, including the Social Circumstances report, contain the information set out in the Practice Direction.

Please provide below the proposed location of hearing and the correct name, job description and direct [3] email and postal address of all the witnesses nominated by the Responsible Authority as responsible for providing written evidence in the manner of statements or reports compliant with the Practice Direction.

If, before the written evidence is submitted to the tribunal, the identity, job or personal contact details of the relevant witness changes, please immediately provide updated information to the tribunal.

Proposed Location of Hearing:


Statement of Information about Patient:


Clinician’s Report:


Nursing Report (if appropriate):


Social Circumstances Report:


I certify that the above information is correct and can be relied upon for personal and direct service by the tribunal of directions and summonses.

Signed on behalf of the Responsible Authority:

Secure email address for Responsible Authority:


The First-tier Tribunal

(Health, Education and Social Care Chamber)

Mental Health

HQ1 Listing

To the Responsible Authority and to the Patient’s Representative.

Please identify all dates within the listing period (specified in the Case Notification Letter (CNL1) & Directions) that are possible for you, and answer the questions below, as far as you are able to.

Offering availability indicates to the tribunal that you and your witnesses are available on the dates listed, and that you will ensure that your witnesses will attend in person or (if approved) by telephone or by video link.

Parties are reminded that they have a legal duty to cooperate with the tribunal and if they fail to return this form within the time limit referred to in the Case Notification Letter (CNL1) the tribunal will assume that all dates within the period identified in the letter are convenient, and will allocate a hearing date accordingly.

If the dates you are offering fall outside of the specified listing window, please submit a listing window extension request on a CMR1 form which can be found here; https://www.justice.gov.uk/forms/hmcts

Efforts will be made to list the case on a date convenient to all parties, but this may not always be possible.

Available dates (please give at least 3 full days or 6 half days within the listing window):


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