Emergencies: 082 800 8727
Questions: 080 000 6942
phclientliaison@platinumhealth.co.za

 

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Emergencies: 082 800 8727  |  Questions: 080 000 6942
phclientliaison@platinumhealth.co.za

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Chronic Medication Delivery Order Form

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PlatComprehensive Chronic Illness Benefit Application Form

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Maternity Visits Specialist Feedback Form

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HIV Management Programme Application Form

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Platinum Health Supplier Information Form

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Group Practice Information Form

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PlatCap Chronic Illness Benefit Application Form

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PlatFreedom Chronic Illness Benefit Application Form

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PlatCap Maternity Programme Registration Form

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PlatComprehensive Maternity Programme Registration Form

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PlatFreedom Maternity Programme Registration Form

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Debit Order Instruction Form

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Radiology Authorisation Request Form

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EX GRATIA APPLICATION FORM

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Membership Continuation Form

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Confirmation of Medical Form

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Case Studies for Prosthesis Form

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Application to be a DSP

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Chronic Medication: How does it work

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Clinical Motivation form Psychiatric Medicine

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