Get Im Fp95 2019-2025

This guide provides clear and supportive instructions for completing the IM FP95 form, which is an application for the certificate of prepayment of prescription charges. By following these steps, users can easily navigate the online process and ensure they submit a complete application.

Follow the steps to fill out the IM FP95 online

1. Press the ‘Get Form’ button to access the IM FP95 form and open it in your preferred online editor.
2. Begin by filling in your title (Mr/Mrs/Miss/Ms/Other) in block capitals, followed by your surname and first name. Ensure that this information is accurate as it will be used for identification purposes.
3. Enter your date of birth in the format dd/mm/yyyy. This information is necessary for age verification.
4. Input your National Health Service number, which is essential for processing your application.
5. Provide your house number or name, street, town, and postcode. Make certain that the address details are correct for correspondence.
6. Include your phone number, which is required for payment inquiries. Optionally, you can provide your email address.
7. Indicate the date from which you would like your prepayment certificate to start. This cannot be more than 7 days prior to or one month after the submission date.
8. Select the desired certificate duration by ticking one box only: a 4-month certificate for £19.00 or a 12-month certificate for £54.00.
9. Choose a payment method by ticking one box: either by cheque or debit/credit card. If using a card, be prepared for a follow-up phone call for payment details.
10. Read the declaration carefully, confirming your understanding of the terms and conditions. Sign and date the form at the designated fields to validate your application.
11. Once you have completed the form, you can save your changes, download the document, print it out, or share it as needed before submitting it by post to the specified address.

Complete your IM FP95 application form online today to save on NHS prescription charges.