Download claim forms, policy change forms and other frequently used forms.
All individual medical insurance schemes
| Bupa Hospital Claim Form(1.66Mb PDF) | Bupa Clinical Claim Form(1.97Mb PDF) |
| Reinstatement Application Form (620Kb PDF) | Bupa Health Insurance Scheme Credit Card Authorisation Form(186Kb PDF) | Bupa Health Insurance Scheme Direct Debit Authorisation Form(208Kb PDF) |
| Pre-authorisation Form (498Kb PDF) | Change of Payment Method and Account Number Form(747Kb PDF) |
| Registration Variation Form(654Kb PDF) | Declaration of Loss Card Form(78KB PDF) |
| Membership Transfer Form(802Kb PDF) | Application Form(2.89Mb PDF) |
| Pre-authorisation Form (498Kb PDF) | Change of Payment Method and Account Number Form(748Kb PDF) |
| Registration Variation Form(766Kb PDF) | Declaration of loss Card Form(78KB PDF) |
| Membership Transfer Form(802Kb PDF) | Application Form(2.95Mb PDF) |
| Registration Variation Form (748Kb PDF) | Decloration of Loss Card Form(78Kb PDF) |
| Pre-authorisation Form(498Kb PDF) | Application Form(1.93Mb PDF) |
| 12-month Interest-free Monthly Instalment Plan Agreement (Diners Club Card)(183Kb PDF) |
| Registration Variation Form (895Kb PDF) | Declaration of Loss Card Form(78Kb PDF) |
| Pre-authorisation Form(498Kb PDF) | Application Form(616Kb PDF) |
| 12-month Interest-free Monthly Instalment Plan Agreement (Diners Club Card)(182Kb PDF) |
| Registration Variation Form (1.52Mb PDF) | Declaration of Loss Card Form(78Kb PDF) |
| Application Form(355Kb PDF) |
| Registration Variation Form (934Kb PDF) | Conversion Form(353Kb PDF) |
| Application Form(358Kb PDF) |
| Registration Variation Form (663Kb PDF) | Change of Payment Method and Account Number Form(646Kb PDF) |
| Registration Variation Form (663Kb PDF) | Change of Payment Method and Account Number Form(646Kb PDF) |
| Registration Variation Form (724Kb PDF) | Application Form(78Kb PDF) |
| Change of Payment Method and Account Number Form(445Kb PDF) |
| Bupa Critical Essential Care Claim Form (2.2Mb PDF) | Change of Payment Method and Account Number Form(371Kb PDF) |
| Membership Change Form(307Kb PDF) | Application Form(485Kb PDF) |
| Reinstatement Form(339Kb PDF) | 12-month Interest-free Monthly Instalment Plan Agreement (Diners Club Card) (180Kb PDF) |
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- 2517 5333Individual schemes:
- 2517 5383Bupa Gold scheme:
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