Call us directly: 0861 111 501
Authorised Financial Service Provider

    Contact Details

    Do you want to add dependents?

    Do you want to add more dependents?

    Do you want to add more dependents?

    Do you want to add more dependents?

    Do you want to add more dependents?

    Do you want to add more dependents?

    As a percentage

    As a Rand value

    Are you currently on a Medical Aid/Gap

    Please upload a Medical Aid Certificate if you are able to provide one

    Where you on a previous Medical Aid/Gap#1?

    Please upload a Medical Aid Certificate if you are able to provide one

    Where you on a previous Medical Aid/Gap#2?

    Please upload a Medical Aid Certificate if you are able to provide one

    Where you on a previous Medical Aid/Gap#3?

    Please upload a Medical Aid Certificate if you are able to provide one

    Chronic Details
    Are you or any of your family members on chronic medication?

    Other chronic details?

    Other chronic details?

    Other chronic details?

    Other chronic details?

    Details

    The Protection of Personal Information (POPI) Act requires us at ABE Medical (Pty) Ltd to inform you how we use, disclose and destroy personal information we obtain from you. We are committed to protecting your privacy and will ensure that your personal information is used appropriately, transparently, securely and according to applicable law. For us to assist you with your query, quotation request or any other problem you might have where we need to provide your information to a 3rd party to solve your problem. Description of the POPIA, Disclaimer and T&C at this link and for this reason we need your consent to continue