Pick n Pay Medical Scheme
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About Us
Board of Trustees
Council for Medical Schemes
Complaints Process
Scheme Rules
Annual General Meeting
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Contributions 2024
Membership Forms
Benefits
Plus Option
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Managed Care
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HealthSaver
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Pick n Pay Medical Scheme
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Home
About
About Us
Board of Trustees
Council for Medical Schemes
Complaints Process
Scheme Rules
Annual General Meeting
Get To Know Your Scheme
Membership
Contributions 2023
Contributions 2024
Membership Forms
Benefits
Plus Option
Primary Option
Managed Care
Complementary Products
Multiply
HealthSaver
Gap Cover
Contact
Blog
Sign in
Forms
Please click on the links below to download the relevant forms:
MEMBERSHIP FORMS
Main member application form
download
download
Changes to your membership
download
download
Option selection form
download
download
Dependant confirmation (over 21)
download
download
Application for ex gratia assistance
download
download
PROGRAMME ENROLMENT FORMS
Palliative Care application form
download
download
Integrated Care Programme application form
download
download
Maternity Programme enrolment form
download
download
YourLife Programme (HIV/AIDS) application form
download
download
Mental Health Programme Enrolment Form
download
download
CHRONIC AUTHORISATIONS
Plus Option chronic medication authorisation process
Primary Option chronic medication application form
download
download
Plus Option chronic medication application form
download
download
Chronic medication advance supply request form
download
download
CONSENT FORM
Consent form: Authorisation for disclosure of information
download
download
CONTACT DETAIL FORMS
Member contact detail form
download
download
Contact details of dependants over the age of 18
download
download