Online Inquiry

Online inquiry – enters the organizations computer system directly, with the help of advanced technology

Online inquiry - Easy, simple, fast, and more effective than any other form of application

Online inquiry - does not limit the continuation of the relationship between the applicant and the organization, it is always possible to chat and meet as needed.

After sending the form, you will receive a return email confirming the receipt of the referral, the referral number in the system will be indicated in the email, this number will help to continue the relationship with the organization to identify your referral, you should mention it in every interaction with the organization.

Personal Information
Level of urgency
Inquiry details
*Kupat Cholim
*Supplementary Insurance
Health insurance / insurance company

Documents can be attached to this form or via Email to  WhatsApp : 03-6351111 or Fax : 03-6351116. Please note Inquiry No.!

Skip to content