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,
Incomplete applications will take longer to process as we may need to contact you for more information.
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.
Drugs Payment Scheme application form (PDF, 231KB, 6 pages) - To apply for the drugs payment scheme by post, download this drugs payment scheme application form in English or LoCall 0818 22 44 78 to order one in the post.
Scéim Íocaíoctaí Drugaí Foirm Iarratais - Drugs Payment Scheme application form (Irish) (PDF, 760KB, 6 pages) - To apply for the drugs payment scheme by post, download this drugs payment scheme application form in Irish or LoCall 0818 22 44 78 to order one in the post.