Get Health Declaration Form Sri Lanka

Completing the Health Declaration Form is an essential step for individuals seeking life insurance coverage in Sri Lanka. This guide will provide you with clear and supportive instructions on how to fill out the form online, ensuring a smooth and efficient process.

Follow the steps to easily complete your Health Declaration Form online.

1. Press the ‘Get Form’ button to access the Health Declaration Form and open it in your preferred editing tool.
2. Fill in the details of the life to be insured in section A. Here you will need to provide the full name, effective date, national identity card number, contact number, and permanent address.
3. Indicate the sex, marital status, and smoking status. Provide your date of birth and calculate your age to enter in the appropriate field.
4. If applicable, provide details about smoking habits such as the number of cigarettes smoked per day. Fill in your occupation, nature of duties, annual income, and employer's name and address.
5. Enter your height and weight in the specified fields.
6. In section B, answer the health declaration questions regarding any current or past illnesses, conditions, hospitalization, insurance applications, hazardous activities, and disability benefits.
7. If you are pregnant, indicate how many months you are along. Additionally, answer the family health history question.
8. If you answered 'yes' to any questions in section B, provide thorough details on the back of the form, including treatment dates and physician information.
9. Read and complete the declaration section to confirm the accuracy of the provided information. Sign and date the form appropriately.
10. After filling out all sections, you can save the changes, download the form, print it, or share it as needed.

Complete your Health Declaration Form online today to ensure a seamless insurance application process.