15.04.2016 - GEPS-AFV-01
FUNCIONARIO EMSSANAI
Para dar cumplimiento a fa circular conjunta externa 016 de 2013 (mayo 15), Ministerio
je Salud y Proteccién Social y Superintendencia Nacional de Salud, es necesario aplicar
el siguiente cuestionario como soporte de entrega de la presente Carta de Derechos ¥
Deberes del Afiliado y Carta de Desempesio.
éPravio al diligenclamiento del formulario de afilacién, la EPS le hizo entrega de SI [—] NO
la Carta de Derechos y Deberes del Afliado y del Paciente?
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