NHIF Forms – All forms [PDF]

KSh 20.00

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Description

Here are the list of 15 forms you will get on this package:

  1. .Download Members Form 
  2. Download Employers Form 
  3. Benefits Package Inpatient/Outpatient Scheme
  4. Amendment Form
  5. Out Patient Claim Form 
  6. Choice Of Outpatient Medical Facility Form 
  7. Treatment Outside Kenya Form 
  8. Referral Form For Overseas Treatment (National Scheme) 
  9. Referral Form For Overseas Treatment (Managed Scheme)
  10.  Hospital Claim Form 
  11. Long Stay Notification Form 
  12. Application Form For Accreditation As A Health Care Provider 
  13. Quality Improvement Checklist For Contracting of Health Facilities 
  14. Intra Vitro Fertilization Preauthorization Form 
  15. Referral Form For PET/CT Scan At H.H Aga Khan University Hospital
  16. Bank Details Form

Amendment Requirements

1. In case of change of spouse one will be required to produce one or more of the following depending on each case-
-Copy of ID for both parties
-Divorce certificate
-Death certificate for deceased spouse
-Coloured passport size photo(s)
2. For change of ID details, one will be required to produce a copy of the National ID.
3. For updating of dependant’s records (child), one will be required to produce birth notification / certificate/immunization (Child Health Card) and/also the necessary documents supporting adoption or fostering of a child and coloured passport size photo(s)
4. For updating of dependant’s records (spouse), one will be required to produce copy of ID, a sworn affidavit from the Magistrate or marriage certificate and coloured passport size photo(s)

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