Please complete, print and sign the questionnaire. Saving is only possible by using the Adobe Acrobat Professional.Questionnaire E106/S1,Please fill in in block lettersSurname, First name..........................................................................................................................Date.
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How to fill out the Fragebogen Zum Formular E 106 online
Filling out the Fragebogen Zum Formular E 106 is an important step in managing your healthcare documentation when residing in Switzerland. This guide will provide you with clear, step-by-step instructions to help you complete the form accurately online.
Follow the steps to successfully complete the questionnaire.
- Click the ‘Get Form’ button to obtain the document and open it for editing.
- Begin by filling in your surname and first name in block letters as requested at the top of the form.
- Enter your date of birth in the specified format to ensure accuracy.
- Provide your address, including house number, country, postal code, and town.
- If this is your first questionnaire, state the date of your settlement in Switzerland.
- Fill in your insurance number from abroad and provide your contact telephone number or email address.
- Input your bank details, including IBAN and BIC, along with the name and address of your bank. Ensure to confirm that the account holder's name matches your details.
- Indicate your civil status by selecting from the options provided, noting if you need to add further documentation for registered partnerships.
- Detail your education, employment, or self-employment information, filling in respective country, employer, and apprenticeship details as guided.
- Complete the family details by adding any relevant information for spouses, partners, or children, if applicable.
- At the end of the form, confirm your statements are truthful, add your place, date, and signature.
- Once you have completed the form, save your changes, and choose to download, print, or share it as needed.
Ensure your healthcare information is up to date by filling out the Fragebogen Zum Formular E 106 online today.
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