Application Form

Application Form for the Mumkindik Project

The Corporate Foundation “BI Juldyzai” was established by BI Group in 2004 with the aim of providing social and medical support to children with special needs.

The Mumkindik Project is a program of the Foundation aimed at ensuring children’s access to high-tech surgeries and consultations with leading international specialists without the need to travel abroad.

Within the framework of the program, the Foundation invites leading foreign doctors to Kazakhstan to provide consultations and perform complex surgeries for children with rare and severe conditions, as well as to train local medical professionals.

At present, the project is implemented in the following medical areas:

  • Cardiac surgery
  • Orthopedics
  • Endovideosurgery

To participate in the project, it is necessary to complete the application form.
Our specialists will carefully review the information provided to determine possible options for assisting your child.

If your child requires a consultation or surgery in another medical specialty, you may also submit an application. The information will be reviewed and considered when planning further activities and expanding the project’s areas of focus.

    Child’s Information

    Full Name of the Child *

    Child’s Personal Identification Number (IIN) *

    Date of Birth *

    Gender *

    Citizenship *

    Region of Residence *
    Region

    City / Village

    Residential Address *

    Contact Phone Number *

    Medical Information

    Primary Diagnosis *

    Date of Diagnosis

    Comorbid Diagnoses

    Does the child have a disability? *

    Disability Group (if applicable)

    Have any surgeries been performed previously? *

    Which surgeries were performed? (if “Yes”)

    Medical institution where the child is under observation *

    Attending Physician’s Full Name

    Request within the “Mumkindik” Project

    Please indicate the type of assistance you would like to receive *

    Please indicate the medical specialty *

    If “Other” is selected, please specify

    Please indicate the doctor from whom you would like to receive a consultation or surgery

    If “Other” is selected, please specify the doctor


    Selection of a mentor is for informational purposes only and does not guarantee consultation or surgery by the specified specialist.

    Does the child require installation or replacement of implantable medical devices?

    If “Other” is selected, please specify

    Does the child require postoperative rehabilitation?

    If “Yes,” please describe in detail

    Applicant’s Information

    Applicant’s Full Name *

    Relationship to the child *

    Applicant’s Personal Identification Number (IIN) *

    Applicant’s Contact Phone Number *

    Family’s Social Status (multiple options may be selected)

    Comment

    Number of children in the family *

    Employment status of the mother / primary caregiver *

    Place of work (organization / sector)

    Position

    Employment status of the second parent / guardian (if applicable)

    Place of work (organization / sector)

    Position

    Documents

    Upload Documents *


    Recommended documents: medical records and conclusions, examination results, disability certificates (if available),
    child’s birth certificate, parents’ or guardian’s identification documents, photo of the child.

    Privacy Policy

    Application Form for Doctors

    The BI Juldyzai Corporate Foundation, established by BI Group in 2004, implements the Mumkindik Project, aimed at developing high-tech medicine in Kazakhstan and providing children with severe and rare conditions access to consultations and surgeries performed by leading international specialists.

    Within the framework of the project, doctors from Kazakhstan and other countries may participate in master classes conducted by invited mentors. To participate in the master class and receive a certificate, please fill out the application form below.

      Doctor’s Information

      Full Name *

      Date of Birth

      Citizenship *

      Country and City of Residence *

      Contact Phone Number *

      Email

      Professional Information

      Medical Specialty *

      Academic Degree / Professional Qualification (if applicable)

      Years of Professional Experience *

      Primary Place of Employment (organization, country) *

      Position *

      Master Class Participation

      Which specialist’s master class would you like to attend? *

      If “Other” is selected, please specify

      How many days do you plan to attend the master class? *

      Documents

      Upload documents (if available)


      Recommended documents: diplomas and certificates; medical license or permit to practice.

      Consents

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