For those included in your application you will need to provide:
- full name
- date of birth
- PPS number
- contact details
You will also need your existing DPS card number, if you had one.
Apply by post
Post the form to:
Client Registration Unit
PO Box 12966
Temporary emergency registration
Your pharmacy may have submitted a temporary emergency registration for you. You will still need to apply for the scheme within 3 months.