Membership Form

The SAMWUMED application can be retrieved by clicking on the logo above. Please print this application form & contact one of our friendly agents so that we can assist you with its completion. Please have ready a copy of your ID document of yourself and your spouse if applicable, birth certificates of minors, pay slip/bank statements of principal member & proof of previous medical aid cover.

Membership Form

The BONITAS application can be retrieved by clicking on the logo above. Please print this application form & contact one of our friendly agents so that we can assist you with its completion. Please have ready a copy of your ID document of yourself and your spouse if applicable, birth certificates of minors, pay slip/bank statements of principal member & proof of previous medical aid cover.

Membership Form

The LA Health application can be retrieved by clicking on the logo above. Please print this application form & contact one of our friendly agents so that we can assist you with its completion. Please have ready a copy of your ID document of yourself and your spouse if applicable, birth certificates of minors, pay slip/bank statements of principal member & proof of previous medical aid cover.

Membership Form

The DISCOVERY application can be retrieved by clicking on the logo above. Please print this application form & contact one of our friendly agents so that we can assist you with its completion. Please have ready a copy of your ID document of yourself and your spouse if applicable, birth certificates of minors, pay slip/bank statements of principal member & proof of previous medical aid cover.

Membership Form

The MEDIHELP application can be retrieved by clicking on the logo above. Please print this application form & contact one of our friendly agents so that we can assist you with its completion. Please have ready a copy of your ID document of yourself and your spouse if applicable, birth certificates of minors, pay slip/bank statements of principal member & proof of previous medical aid cover.

Membership Form

The KEYHEALTH Local Government application can be retrieved by clicking on the logo above. Please print this application form & contact one of our friendly agents so that we can assist you with its completion. Please have ready a copy of your ID document of yourself and your spouse if applicable, birth certificates of minors, pay slip/bank statements of principal member & proof of previous medical aid cover.

Membership Form

The Keyhealth Private application can be retrieved by clicking on the logo above. Please print this application form & contact one of our friendly agents so that we can assist you with its completion. Please have ready a copy of your ID document of yourself and your spouse if applicable, birth certificates of minors, pay slip/bank statements of principal member & proof of previous medical aid cover.

Membership Form

The Stratum GAP COVER application can be retrieved by clicking on the logo above. Please print this application form & contact one of our friendly agents so that we can assist you with its completion. Please have ready a copy of your ID document of yourself and your spouse if applicable, birth certificates of minors, pay slip/bank statements of principal member & proof of previous medical aid cover.

Statutory Compliance Disclosure's

Glopin is committed to providing services that are transparent & fully compliant with the regulations & guidelines as set out in the Financial Advisories & Intermediary Services ACT (FAIS), including the Medical Scheme Act. Please click on the “Disclosures” button to access all our general disclosure information.