Download an application form

To apply for a PruHealth policy by post please follow the steps below:

Download a PruHealth application form (PDF - 28kb).
Print off and complete the application form.
Send the completed form to:
Freepost
PruHealth
Stirling
FK9 4UE

If you have any questions about your application, please call us on 0800 012 1328.

Before applying please ensure you have a copy of our Policy document (pdf, 20KB) and have read the Policy summary (pdf, 20KB).

Get acrobat reader

Note: If you cannot see the blocks on the form for you to fill in your answers when you print, please adjust your printer settings, or call us on 0800 012 1328 and we will post one to you.

PruHealth is a trading name of Prudential Health Limited and Prudential Health Services Limited which are registered in England and Wales. Registered office at Laurence Pountney Hill, London EC4R OHH. Registered numbers 5051253 and 5933141 respectively. Prudential Health Limited and Prudential Health Services Limited are authorised and regulated by the Financial Services Authority.