Forms - for Momentum Medical Scheme and Health4Me members
- Specialist referral
- Momentum Health4Me chronic benefit registration
- Momentum Health4Me HIV benefit registration
- Momentum Health4Me PEP (Post-Exposure Prophylaxis) registration
- Momentum pathology request form
- Momentum radiology request form
- Provider changes to banking details
- Application to join the Momentum Health Solutions GP network/s
- Application to join the Specialist Networks administered by Momentum Health Solutions
- Momentum Medical Scheme - Clinical criteria for registration on the chronic benefit
- Health4Me Network GP Patient Education Pad [English][Afrikaans][Sesotho][isiZulu]
- Psychiatric Application Form - Outpatient Mental Health Benefits
- Psychiatric In-Hospital Event - First Progress Report
- Psychiatric Application Form - Motivation for Psychiatric Admission
- Psychiatric In-Hospital Event - Second Progress Report
- Application to join the Momentum Dental Network
- Member consent for out of benefit dental procedures Fillable
- Request for Acute dialysis
- Request for Chronic renal dialysis