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Forms

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Home Health Care Pack
Including Guidelines, Levels Selection Form and Registration Form.
CINICO Care Pay Card Registration Form

 

Health Questionnaire Form

 

Incident / Complaint Form

 

SHIC Plan Enrollment Form
CINICO health care coverage enrollment and eligibility.
Government Entities Plan Enrollment Form
CINICO health care coverage enrollment and eligibility
Application for Direct Debit
Application form for direct debit payment for monthly SHIC premium.
Claim Form
Health Insurance claim form. Instructions on how to correctly file your claim.
Change in Member Circumstance
SHIC members.
Change in Member Circumstance
Government Entities.
CINICO Card Replacement Form
Card replacement request form.