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I-CARE GROUP PLAN BASIC INFORMATION SHEET

Kindly fill up the following in order for us to get some basic information about you company/organization. Items with red arrow are required fields.
NAME OF COMPANY >
ADDRESS >
Tel. No. >
Mobile phone number >
NATURE OF BUSINESS >
CONTACT PERSON >
POSITION >
E-mail address >
NUMBER OF EMPLOYEES >
PRESENT HMO ('none' if none) >
EXPIRY >



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