Members can download the following forms, however members must not submit them directly to Sizwe Medical Fund if they belong to a company group. Any forms that contain membership data must be sent to the member’s employer via the Human Resources Department. Sizwe Medical Fund only accepts forms from direct-paying members (generally pensioners or individual members not belonging to their company’s medical aid).
 
In order to read these files you will require the Adobe Acrobat Reader.  
 
   
Accident report form (516k)
Fill in when you have needed medical treatment as the result of an accident
   

Application to register a dependant (231k)
Fill in when adding a new dependant on to your medical aid
   

Application for membership form (261k)
Fill in if you are joining the Sizwe Medical Fund as a new member.
   

Benefit option selection (383k)
Fill in if you want to change from your current option

   

Chronic Medicine and Disease Management application form (101k)
Fill in when joining the CHAMPS chronic medication programme
   
Continuation of membership (377k)
Fill in if you want to continue your membership
   

Direct paying member debit order form (197k)
Fill in if you are a new direct paying member (ie, not a member through your employer)
   

Employer Registration (229K)
Fill in if you are a new company joining the Fund
   

Foreign claim questionnaire (360K)
Fill in if you have claimed for medical treatment outside of South Africa
   

GAP Cover claim  (195k)
Fill in if you are claiming for GAP cover
   

Member EFT (200k)
For members to fill in when registering for electronic funds transfer
   

Member record amendment (216k)
Fill in if any of your personal details have changed, such as your address, banking details, advice of marriage, etc.
   

Provider EFT (198k)
For providers to fill in when registering for electronic funds transfer
   

Psychiatric admission (84k)
   

Sizwe provider details (197k)
   

Termination/transfer advice (203k)
Fill in if you are terminating or transferring your membership
   

WellCare Application (89k)
   

WellCare Medication (77k)
   

Wound care (91k)