Get Clinic Empanelment Registration Form - Pedulisihat

Filling out the Clinic Empanelment Registration Form - Pedulisihat online is an essential process for healthcare providers seeking to join the Selcare panel. This guide provides comprehensive, step-by-step instructions tailored to support users of all experience levels.

Follow the steps to complete the form effectively.

1. Click ‘Get Form’ button to access the form and open it in your preferred editing tool.
2. Begin by filling out the clinic name and address. Ensure all details are accurate, as this information is crucial for identification and communication.
3. Provide the contact information, including telephone and fax numbers, as well as the email address for the clinic. This information will be used for correspondence regarding your application.
4. In the section for the person in charge, include their name and position at the clinic. This ensures that the application is processed through the appropriate channels.
5. Detail the business hours of the clinic. This should reflect when the clinic is open and available for patient visits.
6. List the clinic services provided, ensuring to highlight any specializations or additional offerings that may benefit the selection criteria.
7. Confirm the availability of necessary facilities, such as internet and fax machines, which are prerequisites for being part of the Selcare panel.
8. Ensure that a valid Annual Practicing Certificate (APC) is attached with the application, as this is essential for registration.
9. Pay the registration fee of RM 100, and provide the transaction details as specified in the instructions.
10. Once all fields are completed, carefully review the form for any errors or omissions. Make sure all required documents are attached.
11. You can now save changes, download the completed form for your records, print a hard copy for submission, or share it online as needed.

Take the next step in joining the Selcare panel by completing the application form online today.