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Request an appointment

Tell us what care you are looking for and how we should contact you. Reception will contact you to confirm what can be arranged.

Appointment request

Send an appointment request

Share the best way to reach you. Reception will contact you to confirm what is available; sending this form does not make an appointment.

Need care urgently? For a medical emergency, do not use this form: call 112 from a mobile phone or 10177 for an ambulance. For a time-sensitive appointment request, phone reception on 011 394 4754.

Please do not include detailed medical information. This form is not a secure clinical channel; tell us what you need and we will contact you.

We use these details to respond to your request and keep the enquiry on our system so it is not lost. Read our privacy notice.