The Fair Deal application form: how to fill it in

The key facts: the form has seven parts. Every applicant fills in Parts 1 to 4. Part 5 is only for the optional nursing home loan, and Parts 6 and 7 apply to some people only. It is sent, with the documents, to the HSE Nursing Homes Support Office for the applicant’s area.

Where to get the form

The current form is version 4 of the HSE’s Nursing Homes Support Scheme application form. Download the official form here (it is the HSE’s own form, unchanged), or ask your local Nursing Homes Support Office for a copy. The HSE says its staff can also help you complete it, and HSELive answers questions on 1800 700 700.

The form starts with a Quick Reference Guide and Checklist (pages 5 to 11) listing the documents to send. The HSE suggests pulling it out and keeping it beside you while you fill in the form. You do not send the guide back.

The seven parts, one by one

Part 1: the applicant’s details. Name, address, date of birth, PPS number and the details of a spouse or partner. If a relative or friend is helping, their contact details go here too, so the HSE knows who to write to.

Part 2: the care needs assessment. This asks the HSE to assess whether long-term nursing home care is needed. Part 2A is completed by the person themselves. Part 2B is used when the person cannot apply themselves: it can be completed by a “specified person”, which the form says can be a spouse or partner, a child over 18, or a registered doctor, nurse or social worker.

Part 3: income, assets and deductions. This is the longest part and the one that needs the documents. 3A is income, such as pensions, wages, rent and income given away in the last five years. 3B is cash assets, such as savings, shares and money given away in the last five years. 3C is non-cash assets, such as the home, land and other property. 3D is deductions, such as health expenses, prescription charges, mortgage interest and rent.

Part 4: the application for State Support. This is where the form is signed. Part 4A is signed by the applicant. Part 4B is signed instead when the applicant does not have capacity to make decisions about the application, by the person applying on their behalf. The signature also gives consent to the HSE checking certain social welfare details.

Part 5: the nursing home loan. This part is optional. It lets the share of the contribution based on the home or other property be deferred until after death. The form warns that the loan can take several months, because of the official documents involved, and suggests applying for it at the same time as the main application. You do not have to accept the loan if it is approved. The nursing home loan explained.

Part 6: the three-year cap on a farm or business. Only for a family farm or business where a family successor will take it over. Farms and businesses under Fair Deal.

Part 7: co-decision-making agreements. Only where the applicant has a registered co-decision-making agreement.

Who signs it when your parent cannot

If your parent can make decisions about the application, they sign Part 4A themselves, even if you fill in the rest for them. If they cannot, Part 2B and Part 4B are completed by the person applying on their behalf. A specified person can apply for the care needs assessment and for State Support. The optional nursing home loan needs more: usually a registered enduring power of attorney, or a decision-making representative appointed by the Circuit Court. Applying for someone who cannot sign explains each route.

The documents to send with it

The checklist in the form lists every document, part by part. The ones almost everyone needs are bank or savings statements for the last six months for every account, proof of each pension (the form accepts bank statements showing the weekly payment), and proof of any money or property given away in the last five years. Our document checklist builds the exact list for your situation in a few minutes, at no charge.

The mistakes that cause delay

• A missing bank statement, or statements that cover less than six months.
• An income figure on the form that does not match the statements.
• Gifts or transfers in the last five years left out. They count as if the applicant still had them.
• The wrong person signing Part 4, or Part 4B used when the applicant could have signed themselves.
• Leaving the nursing home loan until later, when it could have gone in with the main application.

After you send it

The HSE confirms that the application has arrived, arranges the care needs assessment, and works out the contribution from the documents. Funding is paid only from the date of approval and is never backdated, so a complete form matters. Decisions can be appealed within 40 working days. Already applied? What to do next.

Help with the form

If you would rather not fill in the 40 pages yourselves, our €120 service fills in the official form with you from plain questions, gives you a ready-made letter for each document, and follows the application through to a decision. You still check it, sign it and post it yourself. See the checklist and the service.

Guidance reviewed on 1 November 2026 against the sources below. fairdeal.ie is independent. The HSE decides every application.