MediWallet | Practice sign-up

Practice sign-up

To join this exciting network of forward-thinking practices, simply complete the application form below.


Once complete, you will be directed to a page where you can upload required documentation. One of our consultants will then send you a Service Level Agreement, as well as provide a marketing pack and training. If all required information is provided, your practice will have access to our network within 48 hours.

Click here to download an application form for manual submission.
For any queries please send a mail to to

Business Information ( is required)
Bank Details ( is required) We require your bank details as we settle the practitioner directly and not the patient
Address Information ( is required)
Doctor/Director Information ( is required)
First Name Surname Email Address
Add Doctor/Director
I agree to the MediWallet terms & conditions
MediWallet is operated by FeverTree Finance (Pty) Ltd., FSP 44281, NCRCP6072