Get Application Form For A Practice Number For A Hospice - Bhf

Filling out the Application Form For A Practice Number For A Hospice - BHF is an essential step for healthcare providers looking to deliver hospice services. This guide will walk you through the process of completing the form online, ensuring you have the necessary information at hand to submit your application effectively.

Follow the steps to successfully complete the application form.

1. Click ‘Get Form’ button to obtain the form and open it in the designated editor.
2. Begin by filling out the owner(s) details. Provide the title, initials, first names, ID number, surname, and council number. Ensure that all information is accurate and legible.
3. Proceed to the hospice details section. Enter the company name, effective start date of practice, and VAT number if applicable. Include the discipline and sub-discipline where relevant. Indicate the type of entity (e.g., Proprietary Limited, Closed Corporation, Incorporated Company) by selecting 'Yes' or 'No' as appropriate.
4. Enter the practice postal address and physical address. Make sure to include the postal code and province.
5. Fill in the contact details, including the telephone number, cell number, facsimile number, and email address.
6. If applicable, complete the EDI details section by indicating if you are an EDI user and whether you prefer direct payment into your bank account.
7. Provide your banking details. Ensure to obtain a bank stamp on the banking verification form or submit an original canceled cheque or original letter from the bank confirming your banking details.
8. Complete the declaration section. Read and confirm that all information is correct, sign and date the application, and include your full name and surname.
9. Ensure you have attached all the required certifications, such as ID copies, organizational registration certificates, and proof of membership with the Hospice Palliative Care Association of South Africa.
10. After completing all sections, you can save your changes, download the completed form, print it, or share it as needed. Remember to send the form via registered mail or hand deliver it to the BHF office.

Complete your application form online today to ensure you receive your practice number efficiently.