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Do you have questions about your contract or the succession of your file? Please fill out this form. We ensure that you will receive a personal response as quickly as possible.
Your demand
Fill in the subject of the question
Advance / pledge
AG Ascento
Benefit statement
Complaint
E-Benefits
General information
Hospitalisation Insurance
My Global Benefits
My Healthcare Card
Outpatient care Insurance
Pension/death insurance
Registration / activation / login
Can you please clarify your demand *
Do you want to add attachments (benefit statements, hospital bills)?
Your data
Name*
First name*
Birthdate*
With this information we are able to give you a personalized answer.
Address*
Street
Number
Box
Postal code
Location
Email address*
Telephone number*
Your contract number / Healthcare card number *
* Mandatory fields
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