Main Applicant Details

Spouse / Partner Details

Yes No

Dependent Child Details

Yes No

Child no.: #{{$index+1}}

 

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Acknowledgement

I acknowledge that I will lose the right to cancel the order within the statutory period of 14 working days as we will commence the delivery of an order immediately and before this statutory period ends. Therefore the services will have deemed to have been provided and you will lose the right to cancel your order. I acknowledge that I have British, EU, EEA or Swiss nationality and that all persons to be specified in this application are UK residents. I understand that should any person on this application decide to remain abroad to live or work, then the relevant authorities must be informed and the EHIC returned. The information that I give on this form is correct and complete to the best of my knowledge.
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Main Applicant Details

Title: {{formData.ma_title}}
Forename(s): {{formData.ma_forename}}
Surname:{{formData.ma_surname}}
Date of Birth: {{formData.ma_dob}}
NHS or NI No.: {{formData.ma_nhs_or_ni_no}}
EHIC PIN Number: {{formData.ma_ehic_pin_number}}

Spouse / Partner Details

Title: {{formData.pa_title}}
Forename(s): {{formData.pa_forename}}
Surname:{{formData.pa_surname}}
Date of Birth: {{formData.pa_dob}}
NHS or NI No.: {{formData.pa_nhs_or_ni_no}}
EHIC PIN Number: {{formData.pa_ehic_pin_number}}

Dependent Child Details

Number of Children: {{formData.ca_number}}

Children No.#: {{$index+1}}

Title: {{formData.ca_title[$index+1]}}
Forename(s): {{formData.ca_forename[$index+1]}}
Surname:{{formData.ca_surname[$index+1]}}
Date of Birth: {{formData.ca_dob_d[$index+1]}}-{{formData.ca_dob_m[$index+1]}}-{{formData.ca_dob_y[$index+1]}}
NHS or NI No.: {{formData.ca_nhs_or_ni_no[$index+1]}}
EHIC PIN Number: {{formData.ca_ehic_pin_number[$index+1]}}

Contact information

Address Line 1: {{formData.addressline1}}
Address Line 2: {{formData.addressline2}}
Town or City: {{formData.city}}
County: {{formData.county}}
Country: {{formData.country}}
UK Postcode: {{formData.postcode}}
Phone Number: {{formData.phone}}
Email: {{formData.email}}
Registration fee: £35.00
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Thank you for your order. We are now processing your order.
Please check your email for your confirmation.

Need an E111 Card / Form?

When you travelled in Europe, you used to need an E111 Card to cover some or all of your health costs when travelling in participating countries. The E111 has now been replaced by the EHIC Card, but the principle is the same. Just as with the E111 Health Card, you benefit from NHS funded health insurance – although it is still wise to combine this with your own private health insurance. Also like the E111 form, the new cards are available via the NHS, but if you want to rid yourself of red tape and admin, we can take care of your application. E111 application forms are things of the past, but we’ll make sure your EHIC application is submitted correctly and that you benefit from a 24 hour helpline if you have any questions. Renewing your E111 from couldn’t be simpler – read on to learn more.

Your EHIC Card is valid in these countries:

  • Austria
  • Belgium
  • Bulgaria
  • Croatia
  • Cyprus
  • Czech Republic
  • Denmark
  • Estonia
  • Finland
  • France
  • Germany
  • Greece
  • Hungary
  • Iceland
  • Ireland
  • Italy
  • Latvia
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • Malta
  • Netherlands (Holland)
  • Norway
  • Poland
  • Portugal
  • Romania
  • Slovakia
  • Slovenia
  • Spain
  • Switzerland
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SERVICE FEATURES EHIC APPLICATIONS UK NHS
Online EHIC Application
Multilingual Application
24-hour Support
Application Support & Verification
EHIC Renewal & Expiry Notification
Administration Fee £35.00 Free of charge

About E111 Card Application

If you haven’t travelled in Europe for a while, you may remember that E111 cards gave you a certain amount of health insurance. While they have been replaced by the EHIC, the new cards work in the same way in most European countries. If you get sick or ill while you are abroad, you still benefit from the same kind of assistance the E111 card offered. The new cards are still free from the NHS, but we take the hassle out of applying from them – giving you more time to plan your travel or holiday.

Apply For An E111 Card

We can’t get you an E111 Card, but we can complete the modern day version of the E111 application for you. This will ensure you get a replacement EHIC card quickly and with minimum fuss – so you enjoy all the benefits of the E111 Card when travelling in Europe. When you ask us to apply, we’ll take care of everything and give you 24/7 support. And if you’re curious to know the difference between E111 application travel insurance and the new system, call us – we’re happy to help.

E111 Card Renewal

If you need to renew or replace your E111 Card, we can help. We’ll take care of your application for a new, replacement EHIC Card that will give you all the benefits that you enjoyed with your old E111 card insurance. We’ll make sure renewing your E111 card with the new type of card is hitch-free, and you’ll be glad to know that E111 forms are now things of the past. Better still, when your new card comes up for renewal, we’ll alert you – a service the NHS doesn’t offer, and one that makes sure you are always covered when you travel in Europe.

Get started today, with our quick and simple online application...

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