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Application for organization of medical care for the insured under voluntary medical insurance

  • Processing of applications is carried out only on working days.
  • Saturday, Sunday, public holidays and public holidays are days off.
  • The application, left at the day off, will be processed on the next working day.
  • The application for the organization of medical care, submitted until 12.00 on a working day, is served on the same day.
  • If the application is filed on a day off or after 12.00 on a working day, the application is executed on the next working day after the filing day.
  • Last name: *
  • First name: *
  • Patronymic:
  • Birthday: *
  • Phone number: *
  • Email:
  • Insurance policy series: *
  • Insurance policy number: *
  • The city where it is necessary to organize a medical service: *
  • Type of medical service (medical consultation, research): *
  • Desired date and time of medical service: *
  • Additional Information:
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