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Submit by Email Name: Print Form EIN: Day 1: Day 2: Day 3: Day 4: Activity #: Activity #: Activity #: Activity #: Day 5: Activity #: Activity #: Activity #: Activity #: Day 9: Day 10: Activity #:
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Day 1 - PIMA is the initial enrollment form for the Premium Integrated Medical Aid (PIMA) program.
All eligible individuals who wish to enroll in the PIMA program are required to file day 1 - PIMA.
Day 1 - PIMA can be filled out either online through the PIMA website or in person at a designated enrollment center.
The purpose of day 1 - PIMA is to collect necessary information from individuals who wish to enroll in the PIMA program.
Day 1 - PIMA requires information such as personal details, contact information, medical history, and income details.
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