For Hospitals, Medical Aids & Clinicians

A clinical partner built to plug into your protocols.

MAGC works alongside hospitals, psychiatric facilities, rehabilitation centres and medical aid schemes to extend care beyond discharge. Submit a referral below and our clinical intake team will confirm receipt within 4 business hours.

HPCSA & SACSSP Registered · BHF Recognised · Multidisciplinary Team · POPIA Compliant

Patient Referral Form

Refer a patient

For urgent or same-day referrals, please call our clinical intake line directly rather than submitting this form.

Referring facility / clinician *

Facility / practice name *

Referring clinician *

Contact email *

Contact number *

Patient details

Provide only what's needed for initial contact — full clinical history is exchanged securely after consent is confirmed.

Patient initials *

Patient contact number

Patient consent status *

Reason for referral *

Additional clinical notes

Urgency *

Routine (within 2 weeks)

Priority (within 3–5 days)

Urgent — please call our intake line instead of submitting this form

Submitted information is treated as confidential clinical correspondence and handled in line with POPIA and HPCSA guidelines.

Referral received.

Our clinical intake team will confirm receipt within 4 business hours and follow up with next steps. For urgent cases, please also call our intake line directly.