EasyMed Accounts Terms and Conditions to open an EASYMED ACCOUNT Download the Terms and Conditions, initial on page 1 and sign on page 2. Attached the signed T&Cs when submitting your application Download Application form Name * Surname * Physical Address * Postal Address Email Address Employer Phone * Next of kin's cell * ID number * Date of Birth * Checkbox *Individual Account (N$200/month)Family Account (N$300/month)Corporate Account (N$350/consultation) User 1Name & Surname Birth certificate/ID Choose FileNo file chosenDelete uploaded file User 2Name & Surname Birth certificate/ID Choose FileNo file chosenDelete uploaded file User 3Name & Surname Birth certificate/ID Choose FileNo file chosenDelete uploaded file User 4Name & Surname Birth certificate/ID Choose FileNo file chosenDelete uploaded file User 5Name & Surname Birth certificate/ID Choose FileNo file chosenDelete uploaded file Upload ID (birth certificate) of Users * Choose FileNo file chosenDelete uploaded file Upload signed T&Cs * Choose FileNo file chosenDelete uploaded file Submit