Declaration of Health form

Declaration of Health Form

We would recommend viewing this article Can I reinstate my lapsed policy before sending in this form.

  • You can print a copy of the Declaration of Health Form by clicking on one of the options in the right top corner of the form, this completed form can be:
    • Posted to Irish Life, Lower Abbey Street, Dublin 1.
    • Faxed to customer service on 01 242 2931.
    • Scanned to your PC or Mac and email it to
    • If you have a smart phone you can take a clear picture of the form and email it to

Need more information? – contact us here.

Was this article helpful?
0 out of 1 found this helpful
Have more questions? Submit a request


Please sign in to leave a comment.