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1 New Account Application
Step 1 of 2

Supporting Documents

Please attach certified copies of the following documents to this application.

ALL APPLICANTS

VAT registration certificate
Registration certificate with the South African/Foreign Medical and Dental Council / Pharmacy Council

COMPANIES

Certificate of incorporation (CM1) / Registration certificate (CoR 14.3)
Certificate to commence business (CM46) (if applicable)
List of directors (CM29) / Register of directors
ID Copies of directors

TRUSTS

Resolution of the board of trustees consenting to this application and authorising the signatory/ies to sign on trust's behalf
Trust deed and any amendments thereof
Latest Letters of Authority issued by the Master of the High Court
ID Copies of Trustees

PARTNERSHIPS & INDIVIDUALS

Written consent of spouse if married in community of property
Copy of identity document of each partner/individual

Account Application Form

Download and complete the account application form. Submit as part of your account registration. Download our Credit Account Application Form here

Cash Account Application Form

Download and complete the cash account application form. Submit as part of your account registration. Download our Cash Account Application Form here

Request for Correction

Request for correction or deletion of personal information. Download our Request for Correction Form here

Upload completed application forms and related documents

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2 Account Information
Step 2 of 2

Account


Postal Address


Practice Information


My Account


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