EHIC Application Form

Each person you're applying for will need to provide details of their full name, date of birth and National Insurance Number. If you do not know the dependent child's National Insurance Number, please provide that of the main applicant.

Main Applicant

Spouse / Partner Details

First Dependent Child Details

Second Dependent Child Details

Third Dependent Child Details

Fourth Dependent Child Details

I have read and agree to the website Terms of Service.

I understand there will be a charge of £14.95 payable to

I would like to receive periodic news and EHIC renewal updates.