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Contact Information
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Medical Aid or Hospital Plan?
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Hospital Plan - I don't need savings
Unsure - Quote Both around Budget
Approx. Budget I want to pay
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Companies to Quote
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Discovery Health
Fedhealth
Medihelp
Momentum Health
Bonitas
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Any Pre-Existing Conditions, Chronic or Illnesses to Note?
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This completed questionaire is used for quotation purposes only and a guideline based on this information.
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