Medical claim authorisation form 2026

1. Click ‘Get Form’ to open the medical claim authorisation form in the editor.
2. 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.
3. 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.
4. 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.
5. Complete Section D if signing on behalf of another individual. Provide your name, date of birth, and reason for signing on their behalf.
6. 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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