Prior agreement applicationPrior Agreement Application • January 7th, 2022
Series of procedures will only be reimbursed by Henner if the Medical Advisory Board has granted a prior agreement based on the information in this document, which must be completed by the Practitioner and sent by post, fax or email to:
PRIOR AGREEMENT APPLICATION - DENTAL TREATMENTSPrior Agreement Application • January 24th, 2013
This form must be sent no later than 15 days prior to the date on which treatment is scheduled to begin. Insured person’s surname and first name: HENNER - GMC Id No.:
ContractPrior Agreement Application • January 24th, 2013
HENNER - Simplified private joint stock company - Insurance Broker and Third Party Administrator - Registered capital of
PRIOR AGREEMENT APPLICATIONPrior Agreement Application • October 5th, 2017
Series of procedures will only be reimbursed by Henner if the Medical Advisory Board has granted a prior agreement based on the information in this document, which must be completed by the Practitioner and sent by post, fax or email to:
