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Get Application To Suspend Your Membership - Bupa
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How to fill out the APPLICATION TO SUSPEND YOUR MEMBERSHIP - Bupa online
This guide provides clear and comprehensive instructions on how to complete the Application to Suspend Your Membership form for Bupa online. Our aim is to support you through the process, ensuring you understand each step and can fill out the form accurately.
Follow the steps to successfully complete the application form.
- Click ‘Get Form’ button to obtain the Application to Suspend Your Membership form and open it in the editor.
- Fill in Section A: Your details. Provide your Bupa membership number, first name, surname, title, and date of birth. Ensure you write in capital letters and use black ink.
- Complete Section B: Contact details. Include your residential address, home phone, work phone (if applicable), mobile number, email address, and postal address if it differs from your home address.
- In Section C: Reason for suspension, mark the corresponding box for either overseas travel or financial hardship which applies to you.
- If you indicated you are traveling overseas, fill in Section D. Answer whether everyone on the membership is traveling, and provide your expected return date.
- For Section E: If applying for financial hardship, select the duration of the suspension you wish to request (either 3, 6, 9, or 12 months) and enter the starting and ending dates.
- Review Section F: Declaration. Read the terms of suspension carefully, and sign and date where indicated. Ensure all necessary signatures are completed.
- Before submission, confirm that all sections are completed, and you have signed where required. Do not staple the form.
- Lastly, save the changes if editing online, print the form, or download it for mailing. Send the completed application to the designated address: Bupa GPO BOX 9809 BRISBANE QLD 4001.
Complete your application to suspend your membership online today!
If you are on Overseas Student Health Cover, please call us on 1800 888 942 or email oshc@bupa.com.au before completing this form.
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