Hospital assistance application

Download the three-page form, complete your details and review the service terms before signing.

1. Page 1 — Your detailsPatient, representative, hospital and nominated WhatsApp contact.
2. Page 2 — Your servicePackage selection, payment details, consent and signatures.
3. Page 3 — Terms & ConditionsA concise version covering all 24 clauses of the full service terms.

You can type into the PDF fields or print the form. It does not submit information online or confirm a booking. Confirm service availability and payment instructions with Hospital Saathi before paying.

Read the full Terms & Conditions