Get Application Form For Recognition Of Private Hospitals

Understanding how to properly fill out the application form for recognition of private hospitals is essential for healthcare providers. This guide offers a step-by-step approach to assist you in completing the form accurately and efficiently online.

Follow the steps to complete the application form effectively.

1. Click ‘Get Form’ button to obtain the application form and open it in your preferred online editor.
2. Begin by entering the name of your institution, which may include the hospital, nursing home, clinic, or pathological laboratory, in the designated field at the top of the form.
3. Provide the registration number of your institution in the specified area to verify your official status.
4. Fill in the complete address of the facility, including house number, ward, mohalla, lane, area, city, pin code, and district.
5. Indicate the name of the owner or director of the institution along with their qualifications in the respective fields.
6. Enter the telephone number and email address for communication and inquiries.
7. State the month and year of establishment of your institution to provide a timeline of operation.
8. List any registration details of the institution under other acts, such as PNDT, MTP, or sterilization schemes, in the provided sections.
9. Answer whether the institution has ever been recognized by state or central government and provide additional details if applicable.
10. State if income tax returns have been filed and attach any necessary audit certificates for the past two years.
11. Include details about the investigations, procedures, or services for which recognition is sought.
12. Attach a rate list or charges for services, justifying each fee to showcase transparency.
13. Describe the yearly report of investigations or procedures applied for recognition, including any relevant statistics.
14. Summarize the manpower position of the facility, listing names, qualifications, and the number of trained and untrained staff.
15. Provide detailed infrastructure information, including the number of rooms, laboratories, wards, and examination spaces, and attach a map showing all facilities.
16. Explain the record-keeping system in place for patient records, ensuring that stock and patient registers are maintained accurately.
17. Indicate whether emergency services are available and elaborate on the types of emergency equipment and drugs in stock.
18. List the available equipment for investigations and examinations, noting their makes and models.
19. Describe any arrangements for pathological, biochemical, and bacteriological investigations, including facilities for emergencies.
20. Detail the operation theater specifications, including equipment, anesthesia information, and arrangements for emergencies.
21. Provide any additional information about your institution that may support your application.
22. After filling out all fields, review your application for accuracy and completeness. Once confirmed, save changes, and consider downloading or printing the application for your records.

Complete your application form online today to ensure recognition of your healthcare facility.