CHANGE OF HOSPITAL

You can also click download PDF form and complete it manually, then send it to forms@vhcl.com.ng


    To be completed in CAPITAL LETTERS
    Please complete the form as appropriate.
    Note the red asteriks * for the required fields.
    Thank you for chosing Veritas Healthcare Ltd.


    CHANGE OF PROVIDER Are you changing provider for:

    Kindly state the reason for the change so we can review for any inconveniences, thank you.

    Note: The Information provided shall be kept with utmost confidentiality and shall be used for no other purpose than HMO Registration.