Get Form 165 Generic - Hpcsacoza - Hpcsa Co 2020-2025

Completing the FORM 165 GENERIC is an essential step for those looking to obtain approval to conduct a private practice in radiography. This guide will provide clear, step-by-step instructions on how to fill out the form online, ensuring you meet all necessary requirements for submission.

Follow the steps to fill out the FORM 165 GENERIC online effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in your title, surname, and first name(s) in the designated fields.
3. Provide your registered address, making sure to include all necessary details.
4. Enter your contact information, including your work, home, and cell numbers, as well as your email address.
5. Select your registration category by ticking the appropriate box for diagnostic, ultrasound, nuclear medicine, or radiation therapy.
6. Indicate the date of your initial registration in the specified format.
7. List your qualifications along with the dates you obtained them, ensuring this information is complete.
8. Document your post-registration experience by detailing your employer, your major responsibilities, and the timeframe you worked there.
9. If you are a member of professional associations, list their names in this section.
10. Select the nature of your practice, indicating if it is a solo practice, partnership, or section 54A company.
11. Provide the name of your proposed practice or partnership, ensuring it follows the ethical guidelines.
12. Sign the statement by stating your agreement to the terms and certify that all information is correct.
13. Finally, save your changes, and you can either download, print, or share the completed form online.

Start filling out your FORM 165 GENERIC online today!