GL Application Form

Secure Your Visit with a
Guarantee Letter

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GUARANTEE LETTER APPLICATION

Apply for your Guarantee Letter (GL) early for a faster, hassle-free visit.

We’ll have it ready before your appointment.

  • All fields are mandatory.
  • Guarantee Letter applications must be submitted at least 3 working days before the appointment date.
  • If your appointment is within the next 1–2 days and you are unable to submit online in time, please walk in to our GL Centre (Corporate Patient Centre) as early as possible before your appointment.
  • Walk-in service is subject to processing time and may involve waiting.

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    *Select type of Patient Payor


    *Select Insurance Provider


    *Select Company

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    Outpatient VisitMedication Refill


    *Upload clear referral letter/ appointment letter (PDF, TXT, PNG, max 2MB)


    *Upload clear medication slip (PDF, TXT, PNG, max 2MB)


    *Form must be submitted 3 days prior

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    Success Tick

    Thank you for submitting your
    Guarantee Letter application

    Our team will review it and get in touch with you soon.
    We’d love to hear your feedback to help us improve your experience.