Get Pogs Sickness Benefit Program (sbp)

Filling out the POGS Sickness Benefit Program (SBP) form online is a straightforward process that enables members to access their benefits efficiently. This guide provides detailed instructions on how to complete each section of the form to ensure a smooth application experience.

Follow the steps to fill out the POGS SBP form effectively.

1. Click the ‘Get Form’ button to obtain the SBP form and open it in the editing interface.
2. Complete the 'Date' field by entering the current date of application.
3. Fill in the 'Name of Applicant' field with your full name as it appears on your official documents.
4. Enter your age in the designated 'Age' field, ensuring accuracy for the records.
5. Provide your 'Address' along with 'Contact No.' detailing your current residence and a way to reach you.
6. In the 'Hospital Affiliation' section, name the hospital where you received treatment.
7. Indicate your POGS-MAP membership status by checking the appropriate box for your membership category, such as Fellow, Diplomate, Junior, or Associate.
8. Under 'Hospital confinement', specify where you were confined, including the complete 'Dates' of your hospitalization.
9. Provide a clear 'Diagnosis' that corresponds to your medical condition during hospitalization.
10. If applicable, note any 'Operation' performed during your hospital stay.
11. Have your attending physician complete their section, ensuring they provide their printed name, signature, license number, and PTR.
12. Sign in the 'Signature of Applicant' field to affirm the information provided is accurate.
13. Attach certified true copies of the required documents, including the front sheet of the patient’s medical records and operative records if applicable.
14. Review the form for completeness before finalizing your submission.
15. Once satisfied, save the changes, and download, print, or share the completed form as needed.

Start your application for the POGS Sickness Benefit Program online today.