1. Kindly attach the following 4 documents/pictures

We all hate forms
Feel free to send similar forms obtained from other doctors.
Feel free to use abbreviations and/or refer to other sections.
No need to repeat/copy information from attached files/pics into subsequent part(s) of forms.

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Image

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* 1. ID / drivers copy (patient)

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File
No file chosen

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* 2. Recent ID/portrait photo (patient)

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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No file chosen

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* 3. ID / Drivers licence copy (Account Holder)

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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No file chosen

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* 4. Medical Aid card copy

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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No file chosen
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33% of survey complete.

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