Get Dpsr1 Form

The Dpsr1 Form is essential for individuals and families who are looking to claim refunds under the Drugs Payment Scheme. This guide provides clear and detailed instructions to help users navigate the online form-filling process efficiently.

Follow the steps to fill out the Dpsr1 Form online effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In Part 1, provide applicant's details using block capitals. This includes the Drugs Payment Scheme number, address, PPS number, first name, surname, daytime/mobile phone number, email address, and Eircode.
3. Move to Part 2, where you need to insert the month in which your family's expenses exceeded the co-payment amount. Indicate whether this claim is for a service or item provided by a supplier other than a GMS contracted pharmacy by ticking the appropriate box. If 'Yes', specify the supplier's name.
4. List each family member's DPS number who incurred expenses in the relevant month. Record the pharmacy number, date when items were dispensed, and ensure to confirm that the receipt of items dispensed is attached.
5. In Part 3, read the declaration carefully and confirm that all details are correct. Sign and date the form appropriately to validate your claim.
6. Once all sections are complete, save your changes. You can then download the completed form, print it or share it as necessary before submission.

Complete your Dpsr1 Form online today to ensure you receive your refunds promptly.