NEOHealth KYC Registration

NOTE: PRESALE contributors MUST send an email to whitelist@neohealth.io in addition to completing this form.





No Exchange Addresses. The NEO wallet MUST be from a wallet that you control the private key https://neo.org/client We recommend NEON wallet https://github.com/CityOfZion/neon-wallet/releases
(EXCLUDED: USA, CHINA, SINGAPORE)



Telegram ID is only needed if you are participating in the NEOHealth First Aid Program
Bitcointalk username is only needed if you are participating in the NEOHealth First Aid Program

Medical ID Proof
National ID
National ID Selfie with "NEOHealth" and today's date
Utility Bill (Electricity, Water, Telephone etc) OR Bank Statement NOT older than 3 months (Screenshot if you do not have a paper bill)