Get European Health Insurance Card Application Form

Filling out the European Health Insurance Card Application Form online is a straightforward process that allows individuals to obtain necessary health coverage while traveling in Europe. This guide will provide you with detailed instructions to ensure you complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to access the application form and open it in the document editor.
2. Begin by entering your address information in the designated field. Make sure to include your full address for accurate processing.
3. Next, provide your telephone number and mobile number. This information will be used for any necessary communication regarding your application.
4. Indicate your departure and return dates. This helps in determining the validity of your health coverage.
5. Choose whether you are submitting a new application or a renewal by selecting the appropriate option.
6. Enter your first name(s) and surname in the respective fields. Ensure that the spelling matches your official identification.
7. Provide your gender and date of birth in the specified format: (M/F) and (dd/mm/yyyy). This information is crucial for identification purposes.
8. Affirm your application for the European Health Insurance Card by checking the appropriate box.
9. Fill in your PPS number, ensuring all digits are correctly entered.
10. You will need to declare that the persons listed are ordinarily resident in the Republic of Ireland by signing in the designated area.
11. Review the data protection notice to understand how your information will be used, and then sign and date the form.
12. Once all sections are filled out, you can save your changes, download the completed form, print it for submission, or share it as needed.

Complete your European Health Insurance Card Application Form online today to ensure you have the health coverage you need while traveling!