New Registration/Change Of Banking Details

For an effective registration of a healthcare provider’s practice to switch via the MediKredit switch, or change of debit order banking details with MediKredit:

  • Download the form
  • Complete the required fields 
  • Upload the form
  • Upload the bank letter/statement (not older than 3 months)

For further assistance, please contact our customer care enquiry line on
+27 (0) 860-932-273.

New Registration/Change Of Banking Details

"*" indicates required fields

Type of Application*
Name & Surname*

Upload Documents

Upload completed application form
Max. file size: 64 MB.
Upload bank letter/statement (not older than 3 months)
Max. file size: 64 MB.
This field is for validation purposes and should be left unchanged.