Tarjeta Sanitaria Individual (TSI) in your autonomous community

What you need to have ready

1. Cl@ve or certificado digital/DNIe to do it online. If not, book a presencial appointment at your health centre.
2. Phone and email for notifications and the receipt.
3. Real address where the card will arrive. If you give a wrong one the letter bounces and you lose weeks.

Documentation

1. DNI or NIE (and passport if you’re a non‑EU foreigner).
2. Certificado/volante de empadronamiento reciente (less than 3 months) from your ayuntamiento.
3. NUSS (Número de la Seguridad Social). If you don’t have it, get it at https://importass.seg-social.es/.
4. Resolución del INSS of the right to healthcare or beneficiary document (download from https://sede.seg-social.gob.es/ if you don’t have it yet).
5. TIE/permiso de residencia or certificado de registro de la UE, if applicable.
6. Formulario S1 (if you are a pensioner/insured from another EU country and transfer healthcare).
7. Justificante de Convenio Especial if you don’t have Social Security entitlement and your CCAA offers that option.

Step by step

1. Check your right with the INSS. Go to https://sede.seg-social.gob.es/ and use the service Reconocimiento/consulta del derecho a asistencia sanitaria. If you don’t appear as asegurado or beneficiario, fix that first.
2. Get your NUSS if you don’t have it at https://importass.seg-social.es/ (Área personal > Afiliación y NUSS). It takes minutes.
3. Register on the padrón (or request a volante) at the sede of your ayuntamiento. No padrón, no TSI. Example: Madrid at https://sede.madrid.es/.
4. Request the TSI in your CCAA. Online or with a presencial appointment:
   • Madrid: https://www.comunidad.madrid/servicios/salud
   • Catalunya: https://catsalut.gencat.cat
   • Andalucía: https://www.juntadeandalucia.es/servicioandaluzdesalud
   • Comunitat Valenciana (SIP): https://www.san.gva.es
   • Galicia (Sergas): https://www.sergas.es
   • Castilla y León (Sacyl): https://www.saludcastillayleon.es Search for “Tarjeta Sanitaria Individual/SIP/Alta”.
5. Submit the documents. Online you upload PDFs/photos and sign with Cl@ve/certificado. In person bring originals and copies. If you’re a beneficiary, attach the INSS recognition.
6. Assignment of centre and doctor. They confirm it at the time. They give a resguardo or provisional card.
7. Receive the card. It arrives by post in 1–4 semanas or they print it at the centre (depends on the CCAA). Keep the resguardo for your first appointments.

Time‑saving tricks

1. Fresh padrón: request a volante with a recent date. Some counters reject empadronamientos older than 3 months.
2. Download the INSS right in advance: arriving with that PDF saves trips. If you’re missing as asegurado/beneficiario, the health centre often won’t sort it.
3. Cl@ve avanzada: if you plan to do it online, get Cl@ve upgraded with an in‑person registration first (or use a certificado digital) and you’ll save time.
4. Keep the resguardo: print/save the receipt; it covers you while the physical card arrives.
5. Change of address: update the padrón and notify the health service so they assign the correct centre and the card is posted to the new address.

Common mistakes that will mess up the process

1. Confusing TSI with TSE: the European card doesn’t give you a GP here.
2. Going without padrón or with an old one: you’ll waste the appointment.
3. Not having NUSS or INSS right: they’ll put your file on hold.
4. Uploading blurry photos: they’ll reject them and you’ll lose weeks.
5. Wrong address: the card is returned to sender; you have to start again.
6. Not selecting the correct reason (duplicado/alta/cambio): they process the wrong thing and it delays everything.