Modify Your Details | Vhi Healthcare Exclusive Member Services

Change Contact Details

To modify your personal contact details simply fill out the form
below and submit. The fields marked * must be filled in.

Your Details

	Policy Number	*
	Subscriber's Name (firstname, surname)	*
	Subscriber's Date of Birth (dd/mm/yyyy)	*
	Email Address	*
Change Surname (in case of marriage)

	First Name:
	New Surname:
Change Address

	New Address:



Change Email Address

	New E-mail:
Change Phone Number

	New Daytime Tel:		(area code & number)