Healthy Start » Online application form

Application form for Healthy Start vouchers

Title:
First Name:
Surname:
Date of Birth:
Month Year

National Insurance Number: (do not include spaces)

Tick all the benefits you are getting:

Income related Employment and Support Allowance
Income Support
Income-based Jobseeker's Allowance
Child Tax Credit (with a family income of £16,190 or less per year)
Working Tax Credit (do not tick if you are getting WTC run-on only*)
Universal Credit (with a family take home pay of £408 or less per month)
None of these benefits

* Working Tax Credit run-on is the Working Tax Credit you receive in the 4 weeks immediately after you have stopped working for 16 hours or more per week. If you or your family receive Working Tax Credit, you do not qualify for Healthy Start unless pregnant and under 18

Next Step

Check if you qualify

Find out if you could get Healthy Start vouchers and vitamin coupons by answering a few simple questions.

Check if you qualify

Your questions answered

Got a question about Healthy Start? Find the answers to some common questions about the scheme here.

Find out more

Backdated
vouchers

We have recently been trying to contact some of our Healthy Start
customers regarding payments for missed vouchers.

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Application form for Healthy Start vouchers

What can I buy?

Check if you qualify

Your questions answered