My QR Code Update

Please enable JavaScript in your browser to complete this form.

Form: QR-CODE UPDATE

MEDiQ-R™ Update Form (QR Code)

SECTION 1: IDENTIFICATION

Name (Owner of QR Code) *

First

Middle

Last

Full Name (e.g., as it appears on your ID):

National ID Number: *

Date of Birth (DD/MM/YYYY) *

WhatsApp Contact Number *

Kindly provide contact number to reach you through WhatsApp.

Email Address *

Email

Confirm Email

National ID/Passport Number: *

SECTION 2: UPDATE REQUEST

What would you like to update *

Personal Details e.g. photo, address or contact details
GP / Doctor / Specialist
Medical Conditions
Medications
Emergency Contacts (ICE)
Allergies
Other

Please specify *

Briefly describe the changes you'd like us to make *

Upload any supporting documents or images (optional)

Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.

that ID/Passport update

SECTION 3: CONSENT & CONFIRMATION

Do you confirm that the information provided is accurate and that you request these updates to your QR MEDiTAG profile *

Yes I confirm

Would you like a confirmation once the update is complete *

Yes via WhatsApp
Yes via Email
No confirmation needed

Disclaimer

By submitting this form, you acknowledge and accept the privacy policy of Stainless Charm (Pty) Ltd., including the responsible handling of your personal information.

At Stainless Charm (Pty) Ltd.—encompassing Medical Alert SA, MedAlertSA, LIFEfolio, PawPortal, and MediQ-R—we use only the highest-grade stainless steel for our products. We stand behind our craftsmanship with a Lifetime Warranty against tarnish and corrosion. If your item fails to meet our exacting standards, we will replace it free of charge.

📍 Based in George, Western Cape, we offer nationwide delivery through a reliable courier service, ensuring your jewelry reaches you safely and promptly. Customer satisfaction is our top priority, and we strive to put our clients first in every aspect of our business.

📞 Feel free to reach us on WhatsApp at 083 642 7973. We'd love to hear from you!

Trading Names Disclosure: Stainless Charm (Pty) Ltd. operates under the trading names Medical Alert SA, MedAlertSA, LIFEfolio, PawPortal, and MediQ-R. We are an independent organization and are not affiliated with, or endorsed by, MedicAlert®. Our mission is to provide high-quality alternative solutions designed to assist first responders in quickly identifying critical medical conditions during an emergency.

Thank you for choosing Stainless Charm (Pty) Ltd.

My Account
Search
Search for:
Cart 0