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Individual Group Widow(er) OrphanContinuation as:

Sizwe Medical Fund is administered by 3Sixty Health (Pty)Ltd. For General Enquiries - Monday to Friday | 8am - 5pmTel: 0860 100 871 Email: [email protected]

Silver Saver Plan Gold Ascend PlanPlatinum Enhanced Plan

Gold Ascend EDO PlanPlatinum Enhanced EDO Plan Titanium Executive Plan

Copper Core PlanSelectPlan:

Sizwe Medical Fund is administered by 3Sixty Health (Pty)Ltd. For General Enquiries - Monday to Friday | 8am - 5amTel: 0860 100 871 Email: [email protected] Medical Fund is administered by 3Sixty Health (Pty)Ltd. For General Enquiries - Monday to Friday | 8am - 5pmTel: 0860 100 871 Email: [email protected]


Cardiovascular ConditionsHeart failure, hypertension, shortness of breath(angina), high blood pressure Respiratory ConditionsAsthma, COPD Chronic obstructive pulmonary disease, tuberculosis, bronchitis

Neurological ConditionsStroke, epilepsy, paralysis, weakness, myasthenia gravis

Grastro Intestinal ConditionsGastric/ duodenal ulcer, liver disorder, hepatitis, hiatus hernia, gal bladder stones, pancreatitis

Genito Urinary ConditionKidney stones, prostatic hypertrophy, renal failure glomerolonephros, STI’s (including HIV)

Endocrine ConditionsDiabetes insipidus, thyroid disorders, addison’s disease, diabetes mellitus, osteoporosis

Blood ConditionsAnaemia, blood clotting problems, deep vein thrombosis, leukaemia, lymphoma

Gynaecological & Obstetric ConditionsAbnormal papsmear, abnormal bleeding pregnancy, miscarriage, polycystic ovarian

Mental Health ConditionsDepression, dementia, bipolar disorder, ADHD

Musculoskeletal (back, bone, muscle pain)Arthritis, sarcoidosis, �bromyalgia, ankylosing spondylitis, sjogren’s syndrome

Tumour & GrowthsBreast lumps, cancer, abnormal papsmear, abnormal mogram results, prostate speci�c antigen (PSA)

Ear, Nose and ThroatChronic otitis media, cochlear implant, sinus problems, adenoiditis, nasal surgery

Eyes ConditionsGlaucoma, squint, blurred vision, macular degeneration, ptosis, uveitis, retinal detachment

Are you or any of your dependants expecting to have medical investigations or surgery or planning hospitalisation or treatment in the next 12 months or have you been admitted to hospital in the last 12 months?


Have you or any of your dependants received or not yet received medical advice or treatment for symptoms, not yet diagnosed by a medical professional, in the last 12 months before this application?

Have you or any of your dependants been diagnosed with or received treatment for any conditions not mentioned in the questions above in the last 12 months before this application?


NOTE: If the account holder is not the principal member of the Fund, the principal member agrees to refund monies being paid into the above account and both Sizwe Medical Fund and its administrator, 3Sixty Health, are not responsible for this money once paid.

Sizwe Medical Fund is administered by 3Sixty Health (Pty)Ltd. For General Enquiries - Monday to Friday | 8am - 5amTel: 0860 100 871 Email: [email protected]

As Sizwe Medical Fund we are required by POPIA to explain how we obtain, use, disclose and otherwise process your information, which may include health and financial information (personal information). Sizwe Medical Fund and its administrator (3Sixty Health (Pty) Ltd) will keep your information, including your personal information supplied to us in this application confidential. Acceptance of these terms and conditions is a requirement for activation and servicing of your medical scheme membership. You agree to us processing your personal information for the following purposes:

Sizwe Medical Fund is administered by 3Sixty Health (Pty)Ltd. For General Enquiries - Monday to Friday | 8am - 5pmTel: 0860 100 871 Email: [email protected]

continuation as: select - sizwe

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