Form Ic 1 PDF Details

Travelers undergoing treatment who wish to carry medications containing substances regulated under the Single Convention on Narcotic Drugs, 1961, into Thailand must navigate a specific bureaucratic process. This process is crystallized in the form known as IC-1, mandated by the Royal Thai Government Food and Drug Administration. Essential for those under medical treatment wishing to carry necessary medications across borders, the form serves as an application to legally transport drugs that would otherwise be tightly controlled. Applicants are required to fill in comprehensive details starting from personal information as found in their passport, including full name and nationality, to more specific data such as their residential address and contact information. The form does not accept post office boxes as a valid residential address, emphasizing the government's strict adherence to verifiable details. Moreover, it extends into a detailed declaration regarding the applicant's medical treatment, the medical professional overseeing their care, and the specific medications prescribed – all of which are under the scrutiny of international narcotics control. The I-1 form further probes into the applicant's travel itinerary, questioning about relatives in Thailand, and inquires if the applicant’s medical condition might incur additional medical expenses during their stay. This thorough application process underscores the careful balance Thailand seeks to maintain between upholding international drug control standards and accommodating the medical needs of international travelers.

QuestionAnswer
Form NameForm Ic 1
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesform for ic 12 26 4 6, ic 1 form medication thailand, form ic 1, form ic 2

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THE ROYAL THAI GOVERNMENT FOOD AND DRUG ADMINISTRATION

FORM

IC - 1

APPLICATION FOR

AN INBOUND CARRYING BY TRAVELLER UNDER TREATMENT OF

MEDICAL PREPARATIONS CONTAINING SUBSTANCES UNDER CONTROL OF

THE SINGLE CONVENTION ON NARCOTIC DRUGS, 1961.

PART A – YOUR DETAILS

Please complete using BLOCK LETTERS

1Your full name – as in your passport

Family name

Given names

2Name in your own script or character – if applicable

3Nationality – as shown in your passport

4Details from your passport

Passport number

Country of

Passport

DAY MONTH YEAR

Date of issue

DAY MONTH YEAR

Date of expiry

Issuing authority/

Place of issue as shown in your passport

9Your current residential address – where you can be contacted NOTE : A post office box address is not acceptable as a residential address. Failure to give a residential address will result in your application being invalid.

POSTAL CODE

10Address for correspondence

(If the same as your residential address, write ‘AS ABOVE’.)

POSTAL CODE

11Your telephone numbers – where you can be contacted

COUNTRY CODE AREACODE NUMBER

Office hours

(

)

(

)

 

 

 

 

 

COUNTRY CODE AREACODE

NUMBER

 

 

 

 

 

 

After hours

(

)

(

)

 

 

 

 

 

 

 

12Do you agree to the department communicating with you

by fax, e-mail, or other electronic means?

NO

Yes

COUNTRY CODE AREACODE

NUMBER

5 Sex

Male

6Date of birth

7Place of birth Town/city Country

Female

DAY MONTH YEAR

Fax number

(

) (

)

 

E-mail address

 

 

 

 

 

 

 

 

 

 

 

 

 

13Briefly describe the medical treatment you have received in your home country. If insufficient space, attach an additional statement.

8Country where you live

Continued on next page

14Give details of the doctor in your home country who provided you with medical treatment.

Name and Licence number of doctor.

Address

POSTAL CODE

15Give the expected date of arrival and departure from Thailand and details of arrangement for your continued

care in your home country.

DAY MONTH YEAR

Date of arrival

DAY MONTH YEAR

Date of departure Details of arrangement. If insufficient space, attach an additional statement

16Give details of the medical preparations containing substances under control of the Single Convention on Narcotic Drugs, 1961, which the doctor in your home country arranged for you during your stay in Thailand. (For amounts not exceeding 30 days of treatment)

Details of medical preparations (Trade name, generic name , strength and quantity). If insufficient space, attach an additional statement.

17Give details of your itineraries Embarkation Port

Carrier / Flight number

Disembarkation Port

Carrier / Flight number

18Do you have any relatives or friends in Thailand ?

NO

 

Yes

Give all relevant details

Name of person

Relationship Permanent resident of Thailand ?

NO Yes Address

POSTAL CODE

19During your proposed stay in Thailand, do you have or expect to incur medical costs or require treatment or medical follow up for your medical condition?

NO

 

Yes

Please provide full details.

If insufficient space, attach an additional statement.

PART B – DECLARATION

20Applicant

I declare that the information on this form is complete, correct and up-to-date in every detail.

I will abide by the condition imposed on the permit

granted.

Signature of applicant

DAY MONTH YEAR

Date