Medical Declaration Form Template for Singapore

Create a bespoke document in minutes, or upload and review your own.

4.6 / 5

4.8 / 5

Let's create your Medical Declaration Form

1. Select your governing law and document type:

2. Enter your key requirements:

3. Create your document to edit, review or download

Get your first 2 documents free

Your data doesn't train Genie's AI

You keep IP ownership of your information

Key Requirements PROMPT example:

Medical Declaration Form

"I need a Medical Declaration Form for my Singapore-based medical clinic that includes comprehensive health history sections and specific Covid-19 vaccination status, to be implemented by March 2025 for all new patients."

Document background

The Medical Declaration Form is a crucial document in Singapore's healthcare ecosystem, designed to collect comprehensive medical information from individuals for various purposes including treatment, insurance, employment, or travel. It adheres to Singapore's strict healthcare regulations and data protection laws, requiring accurate disclosure of medical conditions, treatments, and health history. The form serves as both a legal record and a medical reference document, helping healthcare providers, insurers, and other authorized parties make informed decisions while protecting patient privacy rights.

Suggested Sections

1. Personal Information: Basic identification details including full name, NRIC/passport number, date of birth, contact information, and address

2. Medical History Declaration: Comprehensive section for declaring current and past medical conditions, surgeries, hospitalizations, and treatments

3. Current Medications: Declaration of all current prescriptions, supplements, and regular medications being taken

4. Emergency Contact Information: Details of primary and secoNDAry emergency contacts

5. Declaration Statement: Formal statement confirming the truth and accuracy of provided information, with legal implications under Singapore law

Optional Sections

1. Family Medical History: Section for declaring relevant family medical conditions and hereditary diseases

2. Travel History: Details of recent travel, particularly relevant during infectious disease outbreaks

3. Vaccination Records: Section for declaring vaccination status and history

4. Lifestyle Factors: Information about smoking, alcohol consumption, and other lifestyle factors affecting health

5. Insurance Information: Details of medical insurance coverage and policy numbers

Suggested Schedules

1. Schedule A - Medical Reports: Attachment of relevant medical reports, test results, or specialist letters

2. Schedule B - Vaccination Certificates: Copies of official vaccination records and certificates

3. Schedule C - Privacy Notice: Detailed information about data protection rights and medical privacy under PDPA

4. Schedule D - List of Notifiable Diseases: Reference list of diseases that must be declared under Singapore law

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

alex.den.21@genieai.co

Relevant legal definitions

Clauses

Relevant Industries

Healthcare
Insurance
Education
Employment
Travel

Relevant Teams

Human Resources
Medical Records
Compliance
Legal
Risk Management

Relevant Roles

Medical Officer
HR Manager
Insurance Underwriter
Compliance Officer
Healthcare Administrator

How Genie AI reduced drafting time by 75% for a legal firm

Let's create your Medical Declaration Form

Authors

Alex Denne

Find the exact document you need

Long Term Supplier Declaration

Declaration Of Origin

Vat Declaration Form

Sponsorship Declaration Form

Self Declaration Of Surviving Spouse Form

Self Declaration Form Covid 19

Salary Declaration Form

Referee Declaration Form

Medical Fitness Declaration Form

Format Of Affidavit For Declaration

Employee Declaration Form

Digital Referee Declaration Form

Declaration Letter For Visa Application

Declaration And Nomination Form

Affidavit Of Custodian Of Records Form

Supplier Declaration Form

Police Declaration Form

New Declaration Form

Medical Declaration Form

International Declaration Form

Immigration Declaration Form

Declaration Of Trust Form

Declaration Of Goods Form

Declaration Letter For Subsidiary Company

Customs Declaration Form

Custodian Declaration Form

Beneficial Ownership Declaration Form

Arrival Declaration Form

Declaration Of Guarantor Passport

Means Test Declaration Form

Declaration In Application Form

Self Declaration Form For Legal Heir Certificate

IT Declaration Form

Permit Declaration

Declaration Of Financial Support

Statutory Declaration

Occupancy Declaration Form

House Rent Declaration Form

Declaration And Certification Of Finances

Self Declaration Form For Marriage Certificate

Social Declaration Form

Electronic Health Declaration

Declaration Of Finances

Declaration For Application Form

Court Declaration Form

Self Declaration Form For Address Proof

Quarantine Declaration Form

Guarantor Declaration Form

Employee Health Declaration Form

Customs Clearance Form

Third Party Declaration Form

Director Declaration Form

Declaration Of Guardianship

Declaration Form For International Travel

Education Declaration Form

Declaration Form For Passport

Indemnity Declaration

Consent And Declaration Form

Birth Certificate Declaration Form

Visa Declaration Form

Simple Declaration Form

House Declaration Form

Declaration Of Ownership Form

Trust Declaration Form

Self Employed Declaration Form

Land Declaration Form

Company Declaration Letter

Student Declaration Form

Standard Declaration Form

Loan Declaration Form

Guardian Declaration Form

Plagiarism Declaration Form

Employee Self Declaration Form

Beneficial Ownership Declaration

Citizenship Declaration Form