New Patients

Patient Registration

Welcome to Elah Health. Complete this short registration so we can prepare for your first consultation and keep your care personal from the very first conversation.

All information is stored securely in line with POPIA and will only be used by Dr Maretha Rossouw and her clinical team.

Personal detailsFull name (as per ID) *

Preferred name Date of birth

Gender ID or passport number

Contact details

Email address *Phone number *

Physical address

Medical aid (optional)

Scheme Plan / option

Member number Dependent code

Next of kin

Full name Relationship

Contact number

Medical background

Share what you're comfortable with — you can add or update anything during your first consultation.

Known allergies Chronic conditions Current medications and supplements Reason for registering with Elah Health

ConsentsI consent to Elah Health collecting, processing, and storing my personal and medical information as described in the Privacy Policy, in line with the Protection of Personal Information Act (POPIA).I understand that Elah Health offers telemedicine consultations and I consent to receiving clinical care remotely where appropriate, in line with HPCSA guidelines.

Prefer to speak to us first? Email drmaretha@elahhealth.co.za or WhatsApp [CONFIRM: WhatsApp].

If you are experiencing a medical emergency, please call 10177 (ambulance) or 112 (from a cellphone), or go to your nearest emergency department.