Health Authority Mandatory Information Form

Please complete the details below and note that by clicking "submit" at the end of the form, you are consenting to the Sukoon's Data Privacy Policy and also the Bupa Global privacy notice, as applicable.

Personal information

Day invalid

Invalid month

Invalid year

Unfortunately we cannot take new policies for people over the age of 70.

Primary Policy holder must be at least 2 years old

Day invalid

Invalid month

Invalid year

Unfortunately we cannot take new policies for people over the age of 70.

Primary Policy holder must be at least 2 years old

Day invalid

Invalid month

Invalid year

Unfortunately we cannot take new policies for people over the age of 70.

Primary Policy holder must be at least 2 years old

Contact details
If you are a dependent, please answer the below

Please note that by clicking "submit" you are consenting to the Sukoon's Data Privacy Policy and also the Bupa Global privacy notice. 

Helpful terms

Emirate of residence visa:

This is the Emirate from where the member’s visa is issued. If your residence visa was issued in the Emirate of Abu Dhabi, please select "Abu Dhabi" as "Emirate of residence visa", "Residential location" and "Work location".

Residential location

This is the physical location of your home. It can be a sub area in Dubai or any other Emirate in the UAE.

Work location

The physical location of the member’s workplace in the UAE. If the work place varies, use the head office. Also include PO Box number.

Salary

The salary range of the insured member working in the UAE.

Commission

This is to help us identify if the member’s income is based on a variable or fixed salary.

Type of sponsoring entity

This is to clarify the type of sponsoring entity which could be any one of the following:

1. Resident: This is for dependents who are under the sponsorship of a resident expatriate.

2. Citizen: This refers to UAE and GCC nationals including resident expatriates under the sponsorship of a UAE/GCC national (e.g. domestic workers like nanny, driver etc.).

3. Establishment: This is for individuals under the sponsorship of a company established/operating in the UAE.

4. Property Owner: This is for individuals who own a property in the UAE or are under the sponsorship of a UAE property owner.

Entity ID

This is official ID of the sponsoring entity:

1. If the member (spouse or child) is under the sponsorship of a Resident, please provide the UID Number.

2. If the sponsor is a Citizen, please provide the Citizen file number of the UAE/GCC national.

3. If the sponsor is an Employer, please use the code on the Establishment Card used by the company PRO while applying for a visa.

4. If the applicant is a Property Owner, please provide the UID number for the property owner.