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Policy holder information
Your full first name as in passport (the person buying)
Purchaser's full last name as in passport
Date of birth
Email
Code
Phone
Have you received a Residence Permit?
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Are you purchasing this policy for yourself?
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Full name as in passport (person insured)
Full last name as in passport
Date of birth
Email
Code
Phone (person insured)
Preferred start date
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I have read the IPID.
Read the IPID.
I have read the Health Insurance Terms.
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I understand policy cannot be canceled.
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+371 2 799 33 44
karlis.niedra@perks.lv
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