Home Visit

R1200,00

Consultation and examination.
(Includes glucose test and urine lipstick if needed)

Excludes medication, blood tests, IV lines, etc.

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Step 1 of 4

in of Patient

Patient Name

First

Middle

Last

Patient's gender

Patient Phone

If you need an appointment for someone under 18, please provide your own contact details.

Patient Email Address

Confirm Email

If you need an appointment for someone under 18, please provide your own contact details.

Patient's Current Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

(Excludes labs bill).

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