Membership

Become a K&G SANTÉ member to access our services and support our health initiatives.

Identity

Full name *

Date of birth *

Gender *

ID document (optional)

PDF, JPG or PNG, 5 MB maximum.

Phone (WhatsApp if possible) *

Email (optional)

City *

Neighbourhood

Membership type *

This information is optional and will only be used with your explicit consent.

Known allergies

Chronic conditions or ongoing treatment

Usual health centre

Name *

Relationship *

Phone *

I accept the Terms of Use I consent to the processing of my personal and health data in accordance with the Privacy Policy