Welcome to the Medicise Patient Management System (PMS).

Please complete the form below to register for our program. Upon submitting the form, you will receive an account activation email whereafter you may setup an access password.

All information will be held in strict confidence and we adhere to the regulations as set out in the Protection of Private Information Act (POPI).

Create Account

Default

Identity

Title:

First Name:

Surname:

Email Address:

Email (confirm):

Mobile:

Telephone:

South African ID No.:

Passport No.:

Passport Country:

Date of Birth:

Residential Address

Address:

City / Town:

Postal Code:

Country:

Nearest Medicise Medical Centre

Centre Name:

Show another code

Create Account

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Medicise Patient Management System development by PrimeLogic.

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