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How to fill out the Form 165 online
Filling out Form 165 to apply for approval to conduct a private practice is an important step for professionals in the radiography and clinical technology fields. This guide provides clear and supportive instructions on how to complete the form online effectively.
Follow the steps to accurately complete the Form 165
- Press the ‘Get Form’ button to access the application form online and open it in your preferred editing interface.
- Start by entering your DR registration number in the designated field to ensure your application is correctly identified.
- In the 'Title' section, select your title from the dropdown menu or input your title manually as applicable.
- Fill in your surname and first names as they appear on your registration documents.
- Provide your registered address in the address fields, ensuring to include all relevant details for effective communication.
- Enter your telephone, fax, and email details in the respective fields for contact purposes.
- Tick the appropriate category of registration related to your practice (Diagnostic, Ultrasound, Nuclear Medicine, or Radiation Therapy).
- Indicate the date of your initial registration in the specified format (DD/MM/YYYY).
- List your qualifications and the corresponding dates obtained in the qualification section.
- Document your post-registration experience by providing the name of your employer, major responsibilities, and the duration of your employment.
- If applicable, mention any memberships to professional associations, including start and end dates.
- Select the nature of your practice (Solus Practice, Partnership, or Section 54A Company) and fill in relevant details if opting for a partnership.
- Enter the name of your proposed practice or partnership according to the ethical guidelines. Avoid using terms that suggest affiliation with larger institutions.
- Review the statement by applicant section and certify the accuracy of your information by signing and dating the application.
- Once completed, save your changes, and choose to download, print, or share the Form 165 as needed.
Complete your application online today and ensure you meet all necessary steps for a successful submission.
You can obtain Form 16 from your employer as they are responsible for issuing this document to their employees. If you have not received it, check with your HR or payroll department for the issuance procedure. Should your employer fail to provide it, US Legal Forms offers a user-friendly approach to help you access or generate a Form 16 quickly, ensuring you stay compliant with your tax obligations.
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