Nhif Registration Form PDF Details

Securing health insurance through the National Hospital Insurance Fund (NHIF) is a critical step for residents in Kenya, offering them access to a range of medical services and health care provisions. The NHIF Registration Form, specifically referred to as NHIF 26 (Revised 2011), serves as the gateway for members to either register for the first time or update their existing membership details. This comprehensive form collected at P.O. Box 30443, Nairobi, and available through NHIF's official website and dedicated email, encompasses several pivotal sections designed to capture the essential details of the member and their dependents. From the basic identification and contact information, including member's name, ID number, postal address, telephone number, and email, to more detailed requests for changes in the membership profile, the form addresses each aspect meticulously. It also highlights the process for adding a spouse for the first time or changing a spouse's details, requiring specific documents such as ID copies or marriage, death, or divorce certificates for verification purposes. Additionally, the form extends to the registration of children, linking their information to the principal member through birth details and documentation. To complete the registration or update process, members are mandated to attach colored passport size photographs of each person named in the document. Finally, the form enforces an attestation clause where the contributor confirms the accuracy of the supplied information, paralleled by a structured validation procedure involving receiving, verification, amending, and photo processing officers, ensuring that each application adheres to NHIF's stringent requirements for registration or updates.

QuestionAnswer
Form NameNhif Registration Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesnhif online, nhif website, nhif dependant registration form online, nhif registration form

Form Preview Example

NHIF 26 (Revised 2011)

P.O. Box 30443, NAIROBI

Website: www.nhif.or.ke Email: info@nhif.or.ke

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a)

Member Name:

................................................................................................................................................

b)

Member No:

I.D No.:

c)

Postal Address:

................................................................................................................................................

d)

Telephone No:

Email:

e)Requested Changes: .......................................................................................................................................

.........................................................................................................................................................................

.........................................................................................................................................................................

NB:

1.To input the name of a spouse for the 1st time even after a member is already registered, Copies of I.D for Member and spouse is required.

2.To change the name of spouse the following documents will be required:

•Copies of I.D for Member and spouse

•Either marriage certificate/Affidavit from the courts OR Death /Divorce Certificate

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Name of Child

 

 

Date of Birth

 

 

 

 

 

 

 

 

 

 

Date

Month

Year

Gender (M/F)

Birth Certificate No

Birth Notification No

1.

2.

3.

4.

5.

6.

(Please attach photocopies of birth certificates (or birth notification in case the child is 6 months and below)

NHIF 26 (Revised 2011)

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Please attach coloured passport size photographs for each of the person named in part I and II, indicate principal member ID and the name of the person below.

CONTRIBUTOR

SPOUSE

CHILD

Member Name

Spouse’s Name

Child’s Name

.................................................................

.................................................................

.................................................................

Member’s Reg No

Dependant’s No

Dependant’s No

CHILD

CHILD

CHILD

Child’s Name

Child’s Name

Child’s Name

.................................................................

.................................................................

.................................................................

Dependant’s No

Dependant’s No

Dependant’s No

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I certify that the information is correct to the best of my knowledge.

Name of Contributor

Sign

Date

+

1.Receiving Officer_________________________________________ Sign _____________ Date _________

2.Verification Officer________________________________________ Sign _____________ Date _________

3.Amending Officer ________________________________________ Sign _____________ Date _________

4.Photo processing Officer __________________________________ Sign _____________ Date _________

How to Edit Nhif Registration Form Online for Free

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Filling out this document requires attentiveness. Make sure that every single blank field is filled out correctly.

1. It is crucial to complete the online nhif registration accurately, so pay close attention when working with the parts including these specific blank fields:

nhif application writing process outlined (part 1)

2. Now that this part is finished, it is time to include the essential details in Please attach photocopies of birth in order to proceed to the 3rd stage.

nhif application conclusion process clarified (stage 2)

3. This next section should be relatively simple, Member Name Members Reg No, Spouses Name Dependants No, Childs Name Dependants No, CHILD, CHILD, CHILD, Childs Name Dependants No, Childs Name Dependants No, Childs Name Dependants No, I certify that the information is, and Name of Contributor Sign Date - all these fields must be filled out here.

Completing part 3 in nhif application

It's very easy to make a mistake while filling in the CHILD, for that reason make sure you go through it again before you'll submit it.

4. The following paragraph requires your information in the following places: . Make certain to type in all of the needed information to go onward.

this field, next field, and other fields inside nhif application

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