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Declaration
In case you are in need of the Additional Groupama Health Insurance, please fill out (with computer, we do not accept handwritten documents) the Declaration as it follows:
- After printing enter the date and your signature (by hand with a blue pen)
- Cross the box on page 2
- You must bring in 2 copies of the declaration form!
Declaration: you can download the official forms LINK
Instructions for completing
1. Fill in this section with a computer!
- Neptun code: 6 letters and numbers
- Insurance policy number: don't write anything here
2. Make an x with a pen
3. Date: The day you bring in the declaration. Write with a computer or with a blue pen
4. Signiture: Sign by hand with a blue pen
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