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EHIC Application
If you are applying for more than one person the cards will be dispatched together, the details entered below will be used to address the card(s) to.
Enter Details
Identity Details
First Name
Last Name
Gender
Male
Female
Date of Birth
PPSN
Social Security link with
Austria
Belgium
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Malta
Netherlands
Northern Ireland
Norway
Poland
Portugal
Romania
Slovakia
Slovenia
Spain
Sweden
Switzerland
United Kingdom
Home Address
Line 1
Line 2
Line 3
Country
Ireland
County
Cork
Clare
Cavan
Carlow
Dublin
Donegal
Galway
Kildare
Kilkenny
Kerry
Longford
Louth
Limerick
Leitrim
Laois
Meath
Monaghan
Mayo
Offaly
Roscommon
Sligo
Tipperary North
Tipperary South
Waterford
Westmeath
Wicklow
Wexford
Postal Code
Local Health Office
Carlow/kilkenny
Cavan / Monaghan
Clare
Cork - North Lee
Cork - South Lee
Donegal
Dublin North Central
Dublin South City
Dublin South East
Dublin South West
Dublin West
Dun Laoghaire
Galway
Kerry
Kildare / West Wicklow
Laois / Offaly
Limerick
Longford / Westmeath
Louth
Mayo
Meath
North Cork
North Dublin
North Tipp./east Limerick
North West Dublin
Roscommon
Sligo / Leitrim
South Tipperary
Waterford
West Cork
Wexford
Wicklow
Dispatch Address
Tick box to use same address as insured person
Line 1
Line 2
Line 3
Line 4
Country
Ireland
Postal Code
Reset
Proceed
Approve application
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Date expiry
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