European Health Applications
Home
Application Options
EHIC Renewal
EHIC Application
Frontier Worker EHIC Application
Frontier Worker 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
Applicant (Insured Person)
Identity Details
First Name
Last Name
Gender
Male
Female
Date of Birth
PPSN
UK National Insurance No
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
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
Line 4
Postal Code
Application Type
Application Type
Frontier Worker
Family Member Of Frontier Worker
Pensioner
Family Member Of Pensioner
Dependent Type
Dependent Child Aged 0-23 Years
Spouse/partner
Family Member
Identity Details
First Name
Last Name
Gender
Male
Female
Date of Birth
PPSN
UK National Insurance No
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
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
Line 4
Postal Code
Employment Details
Employer's Registered Number
Employer Name
Commencement date of employment
Contract expiry date
Dispatch Address
Tick box to use same as Home Address above
Line 1
Line 2
Line 3
Line 4
Country
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
Postal Code
Contact Details
Email Address
Re-enter Email Address
Phone Number
Reset
Proceed
Approve application
×
Date expiry
Confirm?
×
Dialog Message