All Documents

Editable application forms are now available for you to complete digitally. You can navigate through the form by pressing the down arrow. If you can't physically sign a form, you must sign it digitally. We accept digital signatures from these digital signature providers:

  • SigniFlow
  • DocuSign
  • Quickly Sign
  • Hellosign
  • Santamflow
  • Smart Advice signatures
  • Adobe Sign with certificate

 Advanced illness benefit application form

 Allied therapeutic and psychology extender benefit application form

 Application for addition of dependant

 Application for addition of newborn baby

 Application for additional allied therapeutic and psychology benefits

 Application to join Vitality form

 Application for additional HIV Prescribed Minimum Benefits

 Application for out of hospital management of a PMB condition

 Application for special payments made from the medical savings account

 Chronic illness benefit application form

 Continuation Form

 Debit order authorisation form

 Ex Gratia application form

 HIV PMB application form

 HIVCare Programme application form

 International claims form

 Maternity Benefit

 Membership application form (without underwriting)

 Membership application form (with underwriting)

 Overseas treatment benefit form

 Permission to change banking details

 Permission to make certain information available to a third party

 Pre-assessment request

 Request for additional cover for out-of-hospital Prescribed Minimum Benefit conditions

 Request for additional cover for PMB CDL conditions registered on the CIB

 Request for extended supply for medicine

 Request for pre-exposure prophylaxis

 Request to Reverse the Payment of a Claim that the Scheme Received and Paid

 Screening benefit exception form

 Settlement agreement form

 Transfer from active to retiree

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