Main Account Holder Your Name (required)
NRIC/FIN/Passport Number (required)*
Contact Number (required)
Email(required)
Date of Birth (required) Dependant 1 Name (required) NRIC/FIN/Passport Number (required)* Date of Birth (required)
Dependant 2 Name (required) NRIC/FIN/Passport Number (required)* Date of Birth (required)
Dependant 3 Name (required) NRIC/FIN/Passport Number (required)* Date of Birth (required)
How did you hear of us? (required) ---HealthPal AmbassadorFacebookInstagramGoogleFrom a friend/familyArticlesOthers
Remarks:
*With effect from 1st September 2019 in accordance with PDPC's Advisory Guidelines on the PDPA for NRIC and other National Identification numbers, HealthPal will not be storing any NRIC and other National Identification data in our servers.
As we are providing a Medical Card service partnered with MHC, we seek your understanding that NRIC and other National Identification numbers is still required for setting up your eCard.
I hereby agree to the Terms of Use and that the information provided is correct. We may use your Personal Data for our marketing, product development or other commercialisation purposes.
