Create a maisha account

Please complete the form below to create a Maisha Account. This account will allow you to activate and manage your Maisha Covers.
Please Note: Your Email Address will be your Login ID

Customer Profile (Required)

First Name

Last Name

Age Verification

I Agree that I'm 18 years and above

Telephone

Login Information (Required)

Email Address (Login ID)

New Password

Confirm Password

I am not a Robot (Required)

Please enter the verification code to confirm your identity

Referral Information (Optional)

How did you hear about us?

Select your sales manager