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Medical claim authorisation form 2026
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- Click ‘Get Form’ to open the medical claim authorisation form in the editor.
- Begin by filling out Section A, which includes the particulars of the patient. Enter the patient's name, select their citizenship status, and provide their date of birth along with NRIC/CPF or passport number.
- Proceed to Section B for the additional Medisave payer's details. Fill in their name, date of birth, and relationship to the patient. Ensure you check the appropriate box indicating their status.
- In Section C, specify the purpose of this authorization. Indicate whether you wish to check healthcare information or withdraw from Medisave by selecting 'Y' or 'N' as applicable.
- Complete Section D if signing on behalf of another individual. Provide your name, date of birth, and reason for signing on their behalf.
- Finally, review all entries for accuracy before signing at the bottom of the form. Use our platform’s features to save and share your completed document securely.
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medical claims authorisation form
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