Electronic Application Disclaimer & Declaration
By submitting this KeyHealth Membership Application electronic form, I acknowledge and understand that this submission constitutes a formal application to join KeyHealth Medical Scheme and I will assume full responsibility for the monthly payment of contributions. I further acknowledge that submitting this form constitutes an electronic signature and confirms my acceptance of the terms and conditions applicable to membership of KeyHealth Medical Scheme.
I confirm that this application is submitted as my own voluntary choice to join KeyHealth Medical Scheme and that I have selected my preferred benefit option. I acknowledge that I understand the option selected, including the benefits, rules, and limitations associated with that option.
I confirm that all information provided in this application is true, correct, and complete to the best of my knowledge, and that I authorise the submission of this application based on the details provided.
I acknowledge that KeyHealth Medical Scheme and FinSide Financial Solutions, including any affiliated entities, shall not be held liable for any errors, omissions, or delays arising from incomplete, incorrect, or inaccurate information submitted by me in this application.
I further confirm that I have submitted the required termination of cover with my current medical scheme, where applicable and that I am responsible for cancelling the Sizwe Hosmed debit order with my bank.
I understand and agree that KeyHealth Medical Scheme and FinSide Financial Advisors reserve the right to request additional information, supporting documentation, or verification at any stage in order to assess or process this application.