Get Beneficiary Application Bformb Bpatientsb - Oasismuslimcare

Filling out the Beneficiary Application Form for Patients can seem complex, but with clear guidance, you can navigate the process smoothly. This guide will walk you through each section of the form to ensure you provide all necessary information accurately.

Follow the steps to complete your application effortlessly.

1. Click ‘Get Form’ button to access the Beneficiary Application Form. This will allow you to open the application in a suitable format for completion.
2. Start by entering the patient’s personal details. Include their full name, gender, date of birth, address, phone number, email, marital status, number of children, and employer's details.
3. Complete the next of kin section by providing the name, relationship, address, phone number, and email of the next of kin.
4. In the religious affiliation section, indicate the patient's religion and provide the name and contact information for the Imam or head of their religious body.
5. Fill in the medical details, including the hospital where treatment is received, patient’s hospital number, nature and duration of the ailment, and a brief description of the ailment. Additionally, outline the treatment plan, ward information, and doctor’s details.
6. Under financial details, specify the estimated cost of treatment, how long the treatment will last, and include details about personal finances and funds raised from other sources.
7. Obtain a doctor's attestation confirming that the details provided are accurate. Ensure it includes the doctor’s name, hospital, and signature.
8. Indicate the level of assistance requested from OMCF, whether financial or other non-monetary support, and specify the purpose of the funds needed.
9. Provide consent for personal details to be shared for verification purposes, ensuring that the decision does not impact the application process.
10. After completing the form, you can save changes, download, print, or share the form as required. Finally, submit it to the OMCF office or scan and email it to the provided email address.

Take the next step in assisting yourself or a loved one by completing the Beneficiary Application Form online today.