SPECTRAMED MEDICAL AID SCHEME QUOTE
Benefits, limit information and cost.

help with medical aid Please complete the blocks below and send to me
Get a quote on all the SPECTRAMED MEDICAL AID plan options, rates and information you need.


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

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

NAME

EMAIL

TEL

CITY

HOW MANY ADULTS

YOUR AGE

PARTNER'S AGE

HOW MANY CHILDREN

YOURCURRENT MEDICAL AID AND PLAN

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

AND YOUR PARTNER

HOW MUCH 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:

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

Exclusions and sub - limits apply, see brochures.

helpINVESTIGATE OTHER MEDICAL AIDS!

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2017