Enaya Program

Enrollment Form

Click to start Fill the Enrollment Form Request Submitted

Step 1

Click to start
Step 2

Complete the required information
Step 3

Add dependents
Step 4

Confirm registration

Start Enrollment

* All fields marked with * are required.

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1Complete the required information

2Add dependents

Layout

First Name

Date of Birth

Emirates ID Number

City Number

Email Address

Family Name

Gender

Family Book Number

Area

Mobile Number

Upload Emirates ID

Upload Passport

Upload Family Book

I pledge that all the information mentioned is correct and I authorize the Dubai Health Authority to use the medical information as it deems appropriate for managing the program with the aim of improving quality and increasing efficiency.

Request Submitted

Thank you for completing the required information submission. Our team will now proceed with the review and validation of your policy. Should any further details be needed, we will reach out to you directly.

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Register in Enaya Program

Enrollment Form

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