Get Membership Application Form - Ap Private Hospital & Nursing ...

Filling out the Membership Application Form for the Andhra Pradesh Private Hospitals & Nursing Homes Association is a straightforward process that facilitates your enrollment as a member. This guide provides step-by-step instructions to ensure that you complete the form accurately and efficiently.

Follow the steps to complete the membership application form seamlessly.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Carefully read the introductory section addressed to the Hon. Secretary and note the required registration numbers (Govt., State, District). Fill in the current date.
3. Indicate your desired membership type by specifying the subscription fees for life membership and the payment method (Cash/Draft/Cheque), along with the relevant details.
4. Provide the particulars of your nursing home or hospital. Start with the name and full address. If there are branches, list them with their addresses.
5. Designate a representative by providing their name and qualifications. Make sure to attach copies of the qualifications as instructed.
6. Fill in the address and telephone numbers for your facility. Include the total number of beds available.
7. Indicate if you are a member of other associations and provide the names and membership numbers, attaching copies as necessary.
8. Detail the services available at your establishment, specifying the type of nursing home, general information on specialty units, and attached diagnostic facilities.
9. Complete the staff details section, providing the number of doctors, paramedics, nurses, and additional staff. Indicate compliance with the Minimum Wages Act and employee coverage of PF.
10. Specify if a pharmacy is attached to the hospital and if so, provide the license number.
11. Indicate whether your facility is registered under A.P.P.C.B. and provide details about bio-medical waste disposal.
12. State if your hospital is insured, providing the details of the policy and the assured amount.
13. Answer whether your nursing home is covered under income tax and provide the PAN if applicable.
14. Complete the status section by specifying the ownership structure and providing attached licenses as required.
15. Once all sections are filled out, review the information for accuracy. Save any changes, then choose to download, print, or share the completed form.

Begin the application process online today to secure your membership!