Consultation and Claims

Fill in the form indicated according to your relationship with HB

  1. Provider




    Full Name of the Data Holder
    ID Type:
    No.
    Notification Address
    E-mail
    Type of Operation You Want to Perform With Personal Data:
    Claim Si QueryYes
    Description
    ¿Attach document?


  2. Employee




    Full Name of the Data Holder
    ID Type:
    No.[phone* no-704]
    Notification Address
    E-mail
    Type of Operation You Want to Perform With Personal Data:
    ClaimYES QueryYES
    DESCRIPTION:
    ¿Attach document?


  3. Client




    Full Name of the Data Holder
    ID Type:
    No.[Phone* no-704]
    Notification Address
    E-mail
    Type of Operation You Want to Perform With Personal Data:
    ClaimYES QueryYES
    DESCRIPTION:
    ¿Attach document?


  4. Other




    Full Name of the Data Holder
    ID Type:
    No.[Phone* no-704]
    Notification Address
    E-mail
    Type of Operation You Want to Perform With Personal Data:
    ClaimSi QueryYES
    DESCRIPTION:
    ¿Attach document?