Gp application form 2026

The document is an application form (Form MC1) for Medical Cards and GP Visit Cards in Ireland, which provide free access to healthcare services. It outlines eligibility criteria, the application process, required documentation, and details on how to fill out the form. The form is intended for individuals and families residing in Ireland, including those aged 70 and over. It emphasizes the importance of providing accurate information and necessary evidence of income and expenses to qualify for the cards.

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Click ‘Get Form’ to open the gp application form in the editor.
Begin with Part 1, where you will enter your personal details such as name, address, and PPS number. Ensure all information is accurate and complete.
Proceed to Part 2 to provide details about your spouse/partner and any dependents. Fill in their names, dates of birth, and relationship to you.
In Part 3, detail your income sources. Attach supporting documents like payslips or tax assessments directly through our platform for easy submission.
Next, in Part 4, outline your outgoings and expenses. Include housing costs and childcare expenses, ensuring you attach relevant proof.
Select your preferred doctor in Part 5 by entering their name and practice address.
Complete the Declaration in Part 6 by signing it digitally within the editor. This confirms that all information provided is correct.
Finally, ensure that your selected doctor signs Part 7 before submitting the completed form through our platform or sending it to your Local Health Office.

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