Get Thika Membership Application - Avenue Healthcare

Filling out the Thika Membership Application - Avenue Healthcare online is a straightforward process. This guide provides detailed, step-by-step instructions to help users complete the application efficiently and correctly.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the application form and open it in the editor.
2. Begin filling out the personal details section. Use block letters to complete the following fields: Title, First Name, Middle Name, Surname, and Date of Birth. Remember to provide your Blood Group in the specified field.
3. Continue with your address details by entering your P.O. Box, Physical Address, Town, Employer, and Occupation. Ensure that your contact information is accurate by including your Office Telephone, Fax (if applicable), and Home/Mobile Number.
4. In the allergies section, indicate any known allergies you may have. This information is crucial for your safety and treatment.
5. For emergency contact information, provide the name of a person to contact, their relationship to you, and their telephone or mobile number.
6. Fill out the details of covered dependants, if applicable. For each dependant, provide their First Names, Surname, Date of Birth, Blood Group, Sex (M/F), and Choice of Cover.
7. Review the Benefits and Exclusions information provided on the back of the form carefully. This information is essential to understand what is covered and what is not.
8. Confirm that you have read and understood the exclusions and benefits by signing and dating the application form.
9. Once you have completed the form, review all the information for accuracy. You may then save your changes, download a copy, print it, or share it as needed.

Complete your Thika Membership Application online today for timely processing.