Provider Registration

Kindly note that if you have already registered for web access to another medical scheme administered by VMed Administrators, you will not need to re-register for access to Liberty Medical Scheme.
Complete this Password Registration Form  
Register online for web access by completing this password registration form. For security reasons, you will be required to print, sign and fax the resulting activation request to (021) 657-7571, and your password will be activated upon receipt of your signed request.

Please complete the form below (all fields are required) and then press the Submit button
For an explanation of each form element, move your cursor over each field name
First Name
Surname
E-mail Address
Confirm E-mail
Type Doctor / Provider
Practice Number
Password
Confirm Password