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Filling out the Affidavit of Domestic Partnership is a straightforward process that establishes your domestic partner for benefit purposes at Orange Regional Medical Center. This guide will provide you with clear, step-by-step instructions to assist you in completing the form accurately and efficiently.

Follow the steps to successfully complete the Affidavit of Domestic Partnership.

1. Click ‘Get Form’ button to obtain the Affidavit of Domestic Partnership and open it in your chosen editor.
2. In the first section of the form, enter your full name where indicated as the employee. Make sure it is spelled correctly to avoid any issues.
3. Next, fill in your domestic partner's name in the designated field. This name should match their legal name for consistency.
4. Review the criteria listed in the form. Confirm that you and your domestic partner meet all the requirements outlined, including residency, financial responsibility, and marital status.
5. Affirm your understanding of the relationship and the need to notify the hospital if it ends. This is an important step to ensure compliance with hospital policies.
6. Sign the form, ensuring that your signature is clear and matches your printed name. This signature indicates that you affirm the statements made in the document.
7. Provide your current address in the indicated area of the form to ensure that all entered information is up-to-date.
8. If required, wait for the Benefits Manager's approval and include the date of submission in the designated space, as this step finalizes your application.
9. Once you have completed all fields and verified the information, you can save your changes. If needed, you may download, print, or share the completed affidavit.

Complete your Affidavit of Domestic Partnership online today to benefit from the offerings at Orange Regional Medical Center.