Get Release Of Medical Information Form (romif) - Ntu Ghsi

The Release Of Medical Information Form (ROMIF) allows for the authorized sharing of medical information necessary for processing insurance claims. This guide provides clear, step-by-step instructions to assist you in completing the form online effectively.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the form and access it in your preferred online editor.
2. Fill in the administrative section, which includes your policy or membership number, the policy holder or company name (NTU), patient’s date of birth, patient’s name, and identification number (NRIC/FIN/Passport). Make sure all information is accurate and legible.
3. Provide the plan details, your email address for correspondence, and the patient’s phone number in the designated fields. This information is crucial for effective communication.
4. In the declaration section, indicate your relationship to the patient by circling the appropriate option: patient, parent, spouse, or guardian. Ensure you confirm that all provided information is true and accurate.
5. Sign your name in the signature field, ensuring it matches the name listed above. Date the form to indicate when you completed it.
6. If your contact details differ from those in section A, provide your name, identification number (NRIC/FIN/Passport), and contact number in the space provided.
7. Once all sections are completed, review the form for accuracy. Save any changes made, then download, print, or share the form as needed to submit it to the relevant parties.

Complete your documents online today to ensure a smooth processing experience.