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BPA CORPORATE CARE GROUP MEDICAL UNDERWRITING (10 policyholders MINIMUM) (PLEASE USE BLOCK LETTERS)SECTION 1 Application and Authorization Declaration I hereby request on behalf of the aforementioned

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How to fill out group medical declaration form

01

Obtain a group medical declaration form from the relevant authority or organization.

02

Fill in personal details such as name, date of birth, contact information, and any relevant medical history.

03

If there are multiple members in the group, ensure each member fills out their own section of the form.

04

Review the completed form for accuracy and completeness before submitting it.

Who needs group medical declaration form?

01

Groups of individuals participating in activities such as school trips, sports teams, or corporate events may be required to fill out a group medical declaration form.

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What is group medical declaration form?

The group medical declaration form is a document used to report the medical conditions of individuals in a group.

Who is required to file group medical declaration form?

Employers or group administrators are typically required to file the group medical declaration form for their employees or members.

How to fill out group medical declaration form?

The group medical declaration form must be filled out accurately and completely, providing information about the medical conditions of each individual in the group.

What is the purpose of group medical declaration form?

The purpose of the group medical declaration form is to provide information about the health status of individuals in a group for insurance or medical purposes.

What information must be reported on group medical declaration form?

The group medical declaration form requires information such as the individual's name, date of birth, medical conditions, medications, and any other relevant health information.

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