Patient forms

Completing these forms before your first visit saves time in the rooms and lets the consultation focus on you.

Your personal and contact details, and the details of your next of kin.

Your symptoms, past operations, medicines and allergies, so that the consultation can focus on what matters.

Who is responsible for the account: your medical aid, an insurer, or you as a private patient.

Your consent to examination and treatment, and to the practice processing your health information.

Please bring the completed forms to your first visit, or email them beforehand to admin@drnadirkana.co.za.

Make an enquiry

Tell us what is troubling you and how long it has been going on. The practice replies within two working days.