Singapore Goverment

 

E-Enquiry Form

Instruction

Please take your time to fill up necessary detail below.

*refers to mandatory fields

Personal Particulars
NRIC / FIN.* :
Name*:
Email Address*:

Mobile No*:

Doctor MCR No.(If Applicable)

Licensed HCI?
Yes No
Licensed HCI Name: (If Applicable)
hciIdhttps://elis.moh.gov.sg/elis//onlineEnquiry.do

Licensed HCI Name can be clinic name under (Clinics, Hospitals, Nursing Homes, Laboratories)
Enquiry / Feedback Form
Type*:
Category*:
Attachment:
Maximum file size is 2MB
Subject*:

Message*: