*****INDIA NETWORK HEALTH
INSURANCE ONLINE FORMS****
1.
Membership Form
India Network Membership is
required to purchase health insurance. Your membership id is your home phone number.
2.
Insurance Form (18-69)
* Insurance
Form (70+ Age)
Complete the above form in its entirety
(4 steps). The last step of the process will produce ID card on
the fly. If the above
forms do not work due to office restrictions on scripts, please
use the html insurance form instead:
Insurance Form
(18-69)
* Insurance Form
(70Plus)
3.
Insurance Renewal Form
(18-69) * Renewal Form (70+ Aged)
Us the above forms to renew from
1 day (min) to 12 months (max).
If the php script forms give trouble, please use
the html forms ==>
Renewal Form
for 18-69 *
Renewal Form
70 Plus aged
4.
Add new Visitors
(current members only)
5.
Address Change Form
