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This document is an application form for individuals seeking a certificate of major illness and injury under the National Health Insurance program, detailing personal information, medical history,
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How to fill out Application Form for the National Health Insurance Certificate of Major Illness and Injury

01
Obtain the Application Form from the official National Health Insurance website or your local health office.
02
Fill in your personal details, including your full name, date of birth, and address.
03
Indicate your National Health Insurance number in the appropriate field.
04
Provide details regarding the nature of your major illness or injury, including diagnosis and any relevant medical history.
05
Attach required supporting documents, such as medical certificates, test results, and identification proof.
06
Review the completed form to ensure all information provided is accurate and complete.
07
Submit the Application Form along with supporting documents to the designated health authority either in person or via mail.
08
Keep a copy of the submitted form and documents for your records.

Who needs Application Form for the National Health Insurance Certificate of Major Illness and Injury?

01
Individuals who have been diagnosed with a major illness or injury and wish to receive National Health Insurance coverage for their medical expenses.
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The Application Form for the National Health Insurance Certificate of Major Illness and Injury is a document that individuals must complete to apply for financial support or coverage for serious health conditions under the national health insurance program.
Individuals who are diagnosed with a major illness or have incurred significant injuries that require assistance and coverage from the national health insurance scheme are required to file the Application Form.
To fill out the Application Form, applicants should provide personal details, information regarding their major illness or injury, and any necessary medical documentation. Additionally, they should ensure all sections of the form are completed accurately and submit it to the appropriate health insurance authority.
The purpose of the Application Form is to formally request a National Health Insurance Certificate, which verifies an individual's eligibility for health care coverage related to major illnesses or injuries, thereby facilitating access to necessary medical treatments and financial support.
The Application Form must report personal identification details, specifics about the illness or injury, medical history, supporting documentation from healthcare providers, and any previous insurance coverage information related to the condition.
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