Appointment Info/Consent Form 

Patient Details

Medical Aid Details

Are you the main member?
Have you nominated us as your Doctor by searching for our Practice Number 0651966 on the Bankmed or Discovery Website?

HealthID for Discovery and Bankmed Patients

"HealthID is the technology that gives your doctor fast, up-to-date access to your health information. Once you have given consent, your doctor can use HealthID to access your medical history, gain insight into the benefits of your health plan, make referrals to other healthcare professionals, study your blood test results, and write electronic prescriptions and referrals. Click for more information

Have you given us access to your HealthID using practice number 0651966

Consent and Rates

The estimated rate for doctor’s consultation for most plans and for private patients is R434 excluding the cost of consumables. Bankmed Basic and Keycare patients are exempt from this fee and have unlimited GP visits once they have nominated the practice they are choosing to visit. 

Consent to storage of information

I have read and understand the Terms and Conditions which include the permission to release any medical information necessary to process any claims to the medical schemes. I also consent to my information being stored as per HPCSA guidelines. To view a copy of the Terms and Conditions click here

Consultation Rates

I understand that the services are being provided to me and not the medical aid and that I am therefore, financially responsible for all charges, whether or not my medical aid covers such charges. For more details click here


Mon - Fri: 8:00am - 16:00pm​​

Saturday: Resting

​Sunday: Restoring


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