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Ostomy Association of Singapore

Providing support for ostomates.

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E-Form

E-Form

Online application form for Ostomy Association of Singapore membership. For Ostomates only.

OAS Membership and the issuance of a Medical ID Card are free.

However, please note that improperly completed application forms or inaccurate information provided will incur a $20 administrative fee for corrections, applicable to both membership applications and the issuance of the Medical ID Card.

Full name as per NRIC/passport *

Salutation *

Mr
Mrs
Ms
Mdm

Date of Birth (DD/MM/YYYY) *

Last 3 digits and letter of NRIC/FIN No. (e.g. 123A) *

Type of Surgery *

Ileostomy
Colostomy
Urostomy
No Stoma
Others

Others, please specify:

Date of Surgery (DD/MM/YYYY) *

Name of Hospital *

Residential Address *

Nationality *

Singapore Citizen
Singapore PR
Malaysian
Others

Others, please specify:

Gender *

Male
Female

Marital Status *

Single
Married
Divorced
Separated
Widowed

Race *

Chinese
Malay
Indian
Others

Others, please specify:

Dialect group *

Religion *

Email Address *

Mobile Phone No. *

Home Tel No. *

If not applicable, please state 'NA'.

Highest Educational Qualification *

Present Employment Status *

Self-Employed
Employed Full Time
Employed Part Time
Unemployed
Retired

Name of Employer/Company *

If not applicable, please state 'NA'.

Address of Company *

If not applicable, please state 'NA'.

Position *

If not applicable, please state 'NA'.

Office Telephone No. *

If not applicable, please state 'NA'.

Please state membership in other registered societies. Full Name of Society: *

If not applicable, please state 'NA'.

Title of Office held: *

If not applicable, please state 'NA'.

What is your preferred mode of contact? *

Email
Mobile Phone

Do you want to receive the OAS Medical ID card? *

Yes
No

If yes, please email your photo to: admin@oas.org.sg . Photo minimum size : 3.5cm(w) X 4.5cm (h), Resolution: 300 dpi . Photo is acceptable as long as the facial features are clearly visible

I consent *

I consent to receiving information from time to time from the Ostomy Association of Singapore regarding its activities, programmes and requests for updates of members' particulars.

Acknowledgement *

I understand that the OAS Membership and the issuance of a Medical ID Card are free. However, improperly completed application forms or inaccurate information provided will incur a $20 administrative fee for corrections, applicable to both membership applications and the issuance of the Medical ID Card.

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