Patient Registration

Create your Community Clinic patient account. Please provide accurate information so that your medical record and clinic services can be managed correctly.

Personal information

Your basic patient details

First name *

Surname *

Email address *

Mobile number

Date of birth

Gender

Residential address

Identification

Select the identification category that applies to you

You do not need to have a South African ID number to register. Select the category that matches your current documentation.

Patient type *

South African ID number (Optional)

Passport number *

Nationality *

Visa expiry date

Asylum seeker file number *

Enter the file number shown on your asylum-seeker documentation.

Permit expiry date

Nationality *

Refugee permit number *

Permit expiry date

Nationality *

Clinic branch

Choose the branch you will use

Preferred clinic branch *

Account security

Create the password you will use to sign in

Choose how to create your password *

Create my own password Generate a secure password

Password *

At least 8 characters with an uppercase letter, lowercase letter, number and special character.

Confirm password *

Enter the same password again.

Profile photo

Used for your digital clinic profile

Upload a photo

Choose a JPEG, PNG, GIF or WebP image. Maximum size is 5MB.

Use your camera

Take a profile photo directly from your device.

Next of kin

Emergency contact information

Full name

Mobile number

Relationship

Medical information

Information that may help the clinical team

Medical history

Allergies

Funding information

Tell us how you normally intend to fund your care. Actual consultation payment is handled separately.

Funding type

Medical Aid Provider / Scheme

Membership Number

Plan / Option

Patient Relationship to Membership

Medical Aid details are recorded for clinic verification. Registration does not confirm scheme eligibility, authorisation, benefits or payment.

After registration, check your email and verify your account before signing in.