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How to fill out the Nbcrfli Online online
Completing the Nbcrfli Online application form is essential for accessing healthcare services. This guide provides step-by-step instructions to ensure you fill out the form accurately and efficiently.
Follow the steps to complete the application form with ease.
- Click the ‘Get Form’ button to obtain the application form and open it in your preferred document editor.
- In Section A, complete the details of the main member by entering their surname, first names, and ID or passport number. Ensure to use block letters for clarity.
- Provide the patient's details by filling in their surname, first names, date of birth, residential address, postal address, telephone, facsimile, email, and cell number.
- Review the confidentiality, permission, and confirmation statements. The patient must sign and date at the provided space to affirm their understanding.
- In Section B, the treating doctor should fill in their details, including name, initials, practice number, qualifying degree, HPCSA registration number, and contact information.
- Section C requires clinical information of the patient, such as gender, weight, height, BMI, and waist circumference. The doctor should indicate relevant health history and include specifics for blood pressure and blood glucose results where applicable.
- In Section D, the treating doctor must prescribe medicines consistent with the NBCRFLI Health Plan Formulary. Fill in the diagnosis, ICD10 code, medicine name, strength, and directions for use.
- After all sections are completed, the doctor must sign and date the form, verifying the information against the formulary.
- Finally, return the completed application form by fax or email as indicated in the instructions. Ensure you keep a copy for your records.
Complete your application form online today to access the necessary healthcare services.
The National Bargaining Council for the Road Freight and Logistics Industry (NBCRFLI) is an organization dedicated to promoting fair practices in the road freight and logistics sector. It administers provident funds and ensures members receive their entitled benefits. You can learn more about NBCRFLI services and offerings by visiting the Nbcrfli Online site.
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