Patient
Information Form

Submit your details before
your visit to the practice

Before you visit the practice, kindly fill out the form below, so we may add you to our database.

This practice is contracted out of medical aids. We kindly request that all patients settle their outstanding account on the day of consultation, and then submit their claims to their respective medical aids. Please note that fees may vary substantially from medical aid rates. Any fees outstanding should be paid to Dr CND McIntosh Incorporated.