APPLICATION FORM 1. Name Of the Institution. 2. Address. 3. Tel No. Fax EMail 4. Types of Hospitals/ Diagnostic Lab( Multi specialty Hospitals., Single/Multi Super Specialty Hospitals /Lab & Diagnostic.
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How to fill out the Application Format For Health Department Haryana online
Filling out the Application Format for the Health Department of Haryana is an important process for healthcare institutions seeking empanelment. This guide provides a clear and straightforward approach to completing the application online, ensuring all necessary components are accurately addressed.
Follow the steps to fill out the application form effectively.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin with the 'Name of the Institution' field. Enter the official name of the hospital or diagnostic lab as registered.
- Fill in the 'Tel No.', 'Fax', and 'E-Mail' sections with the correct contact information. Ensure accuracy for smooth communication.
- In the 'Types of Hospitals/Diagnostic Lab' field, select the appropriate category (e.g., Multi-specialty, Single-Multi Super Specialty Hospitals).
- Complete the 'History of the Hospital' section, providing a brief overview of the hospital's track record over the last two years.
- Indicate the 'No. of Beds' in the hospital, a key piece of information for assessing capacity.
- Detail the 'Man Power' section. List the regular medical and para-medical staff, ensuring to adhere to the minimum eligibility criteria specified.
- Complete sections 8-10 by detailing regular staff and medical equipment for different specialties and lab services, as specified in the annexures.
- Review the general physical guidelines ensuring all 'Y/N' questions are answered according to your facilities and provisions.
- Once all sections and questions are completed, save your changes, then proceed to download, print, or share the completed form.
Begin your application process online today to ensure compliance with the Health Department of Haryana.
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