Patient Registration Form
At MemoryCare, we are committed to simplifying the process of registering as a new patient of ours. As such, we have created an Online Patient Registration Form that allows you to complete the form in the comfort and privacy of your own home as well as in your own time. If you prefer, you are also more than welcome to complete the form at our offices using one of our iPads.
Please let us know if you would like a member of our team to call you to help with the Registration process. If you prefer, we are also very happy to complete the form on your behalf during a telephone call at your convenience. To get in touch, please Contact Us using the online form or call us on
+ 27 (0)71 842 2731.
Please follow the steps below to complete our online Patient Registration Form:
1. Have you registered on the MemoryCare website?
No, I have not registered as a user on the MemoryCare website
Yes, I have registered on the MemoryCare website.
2. Now that you have signed in, have you started completing a Patient Registration Form before?