Personal Information

    Guarantor Information

    Medical Aid Information

    Clinical Information

    Important Information

    If you are a PRIVATE PATIENT, it is your responsibility to ensure that you contact the accounts department for a quotation prior to your admission, and MEDICAL AID patients need to obtain an authorisation prior to admission, any shortfalls or copayments will be your own liability, Your MEDICAL AID CARD AND ID DOCUMENT are pre-requisitites for admission otherwise you will be treated as a private patient. PRIVATE WARDS REQUESTS: This will remain your responsibility, and will be subject to availability.