SEPA Payment Registration | Freedom Health Insurance

Account Selection

Account

First name

Last name

Billing email

Account email

Phone

Description (policy number)

Address details

Country

Address Line 1

Address Line 2

Town/City

Postcode

Billing details (these details will be used for invoicing)

Language

Currency

Invoice prefix/policy number (all future invoices will begin with this prefix)

Price (in cents, e.g. €10.99 = 1099)

Billing interval

Product name

Plan nickname

SEPA Direct Debit Details

Name of account holder

IBAN

Start Date

End Date

By providing your IBAN and confirming this payment, you are authorizing Freedom Health Insurance and Stripe, our payment service provider, to send instructions to your bank to debit your account in accordance with those instructions. You are entitled to a refund from your bank under the terms and conditions of your agreement with your bank. A refund must be claimed within eight weeks starting from the date on which your account was debited.

Freedom SEPA Payment Registration Page