Online pre-admissions

Please bring along the following documents:

  • Main member’s ID book.
  • Patient’s ID book.
  • Medical aid scheme card.
  • Doctor’s letter of referral.
  • Medical aid scheme authorisation number (we can assist with this if necessary).
  • The form must be returned to us via e-mail or fax, at least a day before the procedure.

The admission clerk will:

  • Help you complete all the relevant documents. The patient completes this.
  • Assist you in obtaining authorisation from your medical aid scheme. The patient arranges this.
  • Collect the co-payments (if necessary) or private patient upfront deposit.
  • Explain the admission process.
Fields marked with * are required

Doctor's information

Please complete - Full details of patient

Person responsible for account (Main member of Medical Aid)

Employer's detail (Main member/Person responsible for account)

Person to contact in case of emergency / Next of kin

Person with a different address and telephone number.

Main member / Person responsible for account

Current medical history (list all that apply, including herbal supplements and over-the-counter medication)

Facility details