Request for Internal Review. Request for Internal Review 2025

1. Click ‘Get Form’ to open the Request for Internal Review in the editor.
2. Begin by filling in your Last Name, First Name, and Date of Birth (dd/mm/yyyy) in the designated fields.
3. Enter your Member I.D. (9-digit) to identify your case accurately.
4. Select the type of decision you wish to have reviewed by checking the appropriate box.
5. Provide the date on the letter that informed you about the decision (dd/mm/yyyy).
6. Optionally, explain why you disagree with the decision in the provided space. Attach any relevant documents that support your case.
7. Remember to sign and date your request before submission.
8. Finally, send your completed form to the address indicated at the top of your decision letter via mail or fax.

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