Get Voluntary Admed Application Form

Filling out the Voluntary Admed Application Form is an essential step for securing gap insurance coverage. This guide provides clear and supportive instructions to help you accurately complete the form online, ensuring your application is processed without any issues.

Follow the steps to successfully complete the application form.

1. Click 'Get Form' button to obtain the form and open it in your preferred editor.
2. Fill in your employer's details, including the name of your employer, branch if applicable, employee number, and date employed.
3. Provide your personal particulars by entering your title, surname, first names, identity number, date of birth, name and plan option of your medical aid, and medical aid number.
4. List your dependents by entering their first names, surname if different, relationship to you, and identity numbers. If additional space is needed, provide details on a separate sheet.
5. Enter your contact details, including your postal address, physical address, postal code, home phone number, and email address.
6. Choose your cover option and indicate your desired date of commencement of cover. Note that coverage can only start on the first day of the following month.
7. Answer the underwriting question regarding hospitalization expectations, providing details if applicable.
8. Fill in your banking details for claim payments, ensuring you select the correct account type and provide the necessary authorization.
9. Complete the intermediary details section with brokerage name, branch name, advisor name, email address, FSP number, and mobile.
10. Review the applicant declaration section, ensuring all information is accurate and complete before signing and dating the application.
11. Once you have filled out the form, ensure you save changes, and you can download, print, or share the completed form as needed.

Get started with completing your Voluntary Admed Application Form online today!