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Dpsr1 2026
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- Click ‘Get Form’ to open the dpsr1 in the editor.
- In Part 1, enter your Applicant's Details using BLOCK CAPITALS. Fill in your Drugs Payment Scheme Number, PPS Number, and contact information including your address, daytime/mobile phone number, email address, and Eircode.
- Move to Part 2 for Refund Claim Details. Specify the month when your family’s payments exceeded the co-payment amount. Indicate if this claim is for a service/item from a supplier other than a GMS contracted pharmacy by ticking 'Yes' or 'No'. If 'Yes', provide the supplier's name.
- List each family member's DPS number who paid during that month. For each entry, include the GMS Contracted Pharmacy Number, date dispensed, and confirm that you have attached the receipt.
- In Part 3, read the declaration carefully. Ensure all details are accurate before signing and dating the form.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2011 | 4.3 Satisfied (28 Votes) |
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