Forms

Please click on the links below to download the applicable forms

INTERNATIONAL PATIENTS:

Credit card payment form for international patients (payment in USD):  Credit Card INTERNATIONAL Transaction Authorisation  ** Note:  The international USD rate is inclusive of all bank charges and credit card

LOCAL PATIENTS:

Credit card payment form for local patients (payment in ZAR)  Credit Card LOCAL Transaction Authorisation **Note: Credit card payments are subject to a 3% surcharge**