Scheme Forms for Members - Medshield

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Scheme Forms for Members

Scheme Forms for Members

Below are a list of Scheme forms required to make changes or additions to your membership. We include both a manual format and an easily electronic editable format. Please download the editable format to insert the signatures after which the completed form can be emailed to the relevant email address as detailed on the form. The editable electronic format is indicated as “Auto”.

Active Swopping (Change of Principal Member)AutoManual
Advance Chronic Medication requestManual
Change of Banking DetailsAutoManual
Contribution Refund requestAutoManual
Dependant Termination requestAutoManual
Existing Beneficiary Transfer (to another membership)AutoManual
Ex-Gratia Benefits applicationManual
Family Practitioner (FP) NominationAutoManual
Member Application AutoManual
Member Health DeclarationAutoManual
Member Record Amendment – Dependant RegistrationAutoManual
New Born Registration formAutoManual
New Membership – Beneficiary ContinuationAutoManual
Oncology Treatment ApplicationManual
Option Change requestAutoManual
Orthotic & Prosthetic ApplicationManual
PMB ApplicationAutoManual
PMSA RefundAuto
Savings Refund requestAutoManual
Termination request AutoManual
Third Party ConsentAutoManual