HEALTHIER SG REGISTRATION 2023

HEALTHIER SG REGISTRATION 2023

*Required Fields
Please note this Healthier SG registration is for ATA Medical at Anson Road. You may visit our website at https://www.atamed.sg/hsg for more information.

You will receive an email confirmation upon submission of this form. Our staff will follow up with an email to inform you of your status within 3 working days.
NRIC*
Name*
Please indicate your Full Name as per your NRIC
Gender*
Date of Birth*

DayMonthYear
Email*
Phone Number*
Do you have a history of chronic condition(s) such as high blood pressure, high cholesterol or diabetes?*
Please specify your chronic condition(s)*
Would you be keen to undergo health screening with us for chronic conditions?*
Comments
By providing the information set out in this form, I consent to ATA Medical and their representatives and/or agents collecting, using and disclosing my personal data to enrol for Healthier SG and provide me with related medical treatment.
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