Company Information Form

N.B: Please kindly have the following documents ready to upload before filling and submitting the application form:

• Signed Application Terms and Conditions – Download it here
• Signed Client or Customer POPIA Form – Download it here
• CIPC (Company Documents)
• Proof of banking details not older than 3 months (stamped by the Bank)
• Copies of ID Documents of all directors

HPCSA registration
Why do we need these details from you? As a legal entity, the FICA (Financial Intelligence Centre Act) may request proof of these documents from our customers. We are obliged to abide by the ACT or face penalties and legal action should we not comply. Your HPCSA registration documents serves as proof that you are a medical professional and have access to our medical range. We thank you for your patience and understanding.