Download Zwischen-Abschlussbescheinigung PDF 60 KB - deutscherring-kranken 2026

1. Click ‘Get Form’ to open the document in the editor.
2. Begin by entering your insurance number at the top of the form. This is essential for identification purposes.
3. In section 1, fill in the patient's name, including both last name and first name.
4. Provide the patient's date of birth in section 2.
5. For section 3, enter the diagnosis or ICD code as provided by the healthcare professional.
6. Indicate the duration of any hospital treatment in section 4, specifying both start and end dates.
7. If applicable, note any periods of leave during treatment in section 5 with corresponding dates.
8. Complete sections 6 through 9 with details regarding treatment necessity and insurance type.
9. For the insurer's information, fill out sections 10 to 12 with your address and bank account details.
10. Finally, ensure all required signatures are added before saving or exporting your completed form.

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