Schlumberger Short Term International Assignments – Healthcare Coverage

Employee Details

PLEASE MAKE SURE ALL DETAILS ARE CORRECT. CARDS WILL BE ISSUED WITH THESE DETAILS.

Last Name/Family Name
First Name

Date of Birth

GIN Number
Gender
Country/Countries Of Assignment
Nationality
Current location
Home Address
Address Post Code
Address Country
Bupa require a full correspondence address for all members.
Email Address

Coverage Details

Date Of Commencement Of Assignment

Date of Completion of Assignment
( if known )

Length of Cover

Please note that the minimum period of cover selected must be 2 months, regardless of whether the duration of assignment is shorter.

Legal Entity Details (for invoicing)

Legal Entity Name
Full Address
Finance Information
Please provide any details here that are necessary for the processing of this invoice eg: AU/AC codes, Purchase Order/ Non PO or other cost code details

Does this invoice need to be uploaded to My Supplier?YesNo
Do you require an original paper invoice?YesNo

HR Contact Details

Last Name/Family Name
First Name
Email Address