Patient Registration Form
Payment Arrangements
Patients settle their account on the day of consultation. The practice accepts cash and credit cards. Please note that American Express / Diners and R.C.S cards are not acceptable. The patient will be provided with a detailed statement.
We do not liase with any medical aids, and the patient is responsible for submitting the provided statement to their own medical aid for reimbursement.
Our address is
Suite 507, 5th Floor
Sea Point Medical Centre
11 Kloof Rd
Sea Point
8005
T: +27 21 424 4352
E: admin@capetowndermatologist.com
W: www.capetowndermatologist.com
For an appointment please send an email to admin@capetowndermatologist.com with the following details:
• Your full name
• Indicate if you are a new or existing patient
• The main reason for the appointment
• Contact telephone number
I will try to respond in 24 hours provided it is not over the weekend or holiday.
Please read, download and complete the Patient
Registration Form and bring this with you to the practice. It will answer most of your questions and help keep administrative tasks to a minimum.
Please do not email it to the office.
You may also complete the form at the office.
Thank you for your continued support.
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