Forms and Links

hrForms and Links

To make it faster and easier to purchase and use VZP private health insurance, we have provided these useful forms and helpful web links:

1. Medical Claim Form

Gold Plan

link

Silver Plan

link

Bronze Plan

link

2. Prescription Claim Form for Silver plan link

3. Notification of Change of Address or Termination link

4. Embassies and Consulates link

5. Payment/Deposit form to Raiffeisen Bank, ČR link

6. Raiffeisen Bank branches link

7. DHL rates link

8. Travel and Schengen Claim Form link

9.Physician’s Report for Pregnancy or Exclusive plan link

10. VZP ČR Public Insurance link

11. Terms and Conditions

Gold Plan

English

Český

Silver Plan

English

Český

Bronze Plan

English

Český

12. Application for Foreigners link

13. Application for Foreigners Exclusive link

14. Application for Entrance Exam link

15. Attach File

Name*

Email*

Phone*

Type Of Document *
Passport/IDUniversity LetterPayment/Deposit form to Raiffeisen Bank, ČRMedical Claim FormTravel and Schengen Claim FormNotification of Change of Address or TerminationPregnancy/Physician's examination reportOther

Attached File*