Get Medisave Authorisation Form

The Medisave Authorisation Form is essential for individuals seeking to withdraw funds for outpatient treatments through their Medisave account. This guide provides clear, step-by-step instructions for filling out the form online to ensure a smooth process.

Follow the steps to complete the Medisave Authorisation Form online.

1. Press the ‘Get Form’ button to access the Medisave Authorisation Form and open it in an online editor.
2. In Part I, enter the particulars of the patient, including their name, NRIC or birth certificate number, and whether they are insured under MediShield. If applicable, provide the passport number for foreigners and indicate if a claim from MediShield is desired.
3. In Part II, provide the particulars of the Medisave account holder, including their name and NRIC or CPF number.
4. In Part III, detail the purpose of the withdrawal by specifying the medical institution where charges were incurred and indicate the type of treatment (dialysis, chemotherapy, scans, etc.). Specify the calendar year and the duration for which the withdrawal is requested.
5. In Part IV, authorize and declare your relationship with the patient. Include your name, signature, and date. Ensure that you allow the necessary deductions from your Medisave account.
6. In Part V, if you are the patient, provide your authorization for the medical institution and the Ministry of Health to disclose necessary information. Include signatures, witnesses, and dates where required.
7. If applicable, fill out Part VI, certifying the patient's condition and obtain the doctor's signature, registration number, and hospital stamp.
8. Once all sections are completed, you can save the changes, download, print, or share the Medisave Authorisation Form as needed.

Complete your Medisave Authorisation Form online today for a seamless processing experience.