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Member communication

Application forms

Editable application forms are now available for you to complete digitally. You can navigate through the form by pressing the down arrow. If you can't physically sign a form, you must sign it digitally. We accept digital signatures from these digital signature providers:

  • SigniFlow
  • DocuSign
  • Quickly Sign
  • Hellosign
  • Santamflow
  • Smart Advice signatures
  • Adobe Sign with certificate

Advanced Illness Benefit application form

Application for addition of dependants

Application for out-of-hospital treatment of a Prescribed Minimum Benefit condition

Application for registration of a newborn baby

Applying to become a member of MEDiPOS Medical Scheme

Applying for cover for lymphoedema

Becoming an employer contact

Chronic Medicine Benefit application form

Foreign claim form

HIV PMB application form (Request for additional cover from the Prescribed Minimum Benefits)

Hospital admission feedback

HIVCare Programme application form

Pre-assessment request

Permission to make certain information available to a third party

Request for additional cover for out-of-hospital Prescribed Minimum Benefit (PMB) conditions

Request for additional cover for Chronic Disease List (CDL) conditions registered on the Chronic Medication Benefit

Request for extended supply of medicine

Request for pre-exposure prophylaxis prep

Request to change banking details

Request to reverse the payment of a claim paid by MEDiPOS Medical Scheme

Termination of membership form

Transfer from active to retiree status

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