Looking for a 2017 MEDIHELP MEDICAL AID QUOTE?
Application, benefits, plans and cost.

Please complete the blocks below and send to me. Get all the plan options, rates and information you need.
Need Medihelp Medical Aid.

DO YOU HAVE TO JOIN YOUR EMPLOYER'S MEDICAL AID?
YES     NO

ONLY HOSPITAL COVER?
YES     NO WANT DOCTOR, DENTIST, CHEMIST, GLASSES AS WELL

NAME

EMAIL

TELEPHONE

CITY or TOWN

How many ADULTS

Your AGE

Partner's AGE

How many CHILDREN

Your CURRENT MEDICAL AID AND PLAN?

TOTAL YEARS IN YOUR LIFE YOU HAVE BEEN A MEDICAL AID MEMBER?
AND YOUR PARTNER?

How much can you AFFORD EACH MONTH?

Any CHRONIC CONDITIONS?

WHAT DO YOU WANT FROM A MEDICAL AID?

Receive my informative letter on personal financial matters? Yes

Please note:

  • The submission of this request does not constitute any legal obligation, either on your or Peter J Pyburn's behalf.
    It is simply a request to get some medical aid options.
  • All information provided will be strictly confidential at all times and will be freely transmitted to the email address provided.
    Peter J Pyburn will not be responsible should the information be incorrectly transmitted or not reach the correct recipient.
  • Your email address will never be given to any other person or organisation.
    (I would never be in business if this happened!)
  • YOU MUST CONSULT THE SCHEMES BROCHURES FOR COMPREHENSIVE BENEFIT DESCRIPTIONS AND CONSULT THE SCHEME
    DIRECTLY FOR ANY UNDERWRITING CONCERNS.
  • AT ALL TIMES, THE SCHEME RULES WILL OVERRIDE ANYTHING PETER J PYBURN HAS SAID OR WRITTEN AND AS SUCH YOU
    AGREE WITH THE DISCLAIMER AS PRESENTED IN THE QUOTE/S YOU HAVE ACTED UPON.

I confirm that I have read and understood the notes above. Yes

Exclusions and sub - limits apply, see brochures.

medihelp medical aidINVESTIGATE OTHER MEDICAL AIDS!

income protectionlife insurance quotepeter pyburn brokermedihelp quotemedihelppyburn@peterpyburn.co.za



Disclaimer Disclosure

2017