Physician Services / Prior Approvals

Dear Physician Service Providers ,
Please be aware complete the missing details as in beneficiary card.
Please complete the data missing for English Only.
All attached downloads must be Original and Clear.
Sincerely!

Select Action Physician*

Governorate*

Area / Branch*

Majors*

Date of Visit*

Date of Visit

Date of Service*

Date of Service

Value Of Service*

Endurance Ratios*

Beneficiary's Copayment*

Beneficiary's Card*

Beneficiary's National ID*

Physician Prescriptions*

Swagrass Form*

Report Case

Beneficiary's Phone Number*

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