Get Nhis Apply Online

The Nhis Apply Online application form is an essential document for health care facilities seeking credentialing. This guide provides a step-by-step approach to effectively complete the form, ensuring all required information is accurately provided.

Follow the steps to complete the application form successfully.

1. Click ‘Get Form’ button to obtain the application form and open it in the designated editor.
2. Begin by entering the name of your health care facility in the provided space.
3. Select the type of facility by ticking the appropriate box from the options provided, such as CHPS Compound, Maternity Home, Clinic, etc.
4. Indicate the facility ownership by ticking the corresponding box for Government, Mission, Quasi-Government, or Private.
5. Choose the category of application by indicating if it is a new application, renewal, upgrade, re-accreditation, or other, and specify if necessary.
6. Fill in the credentialing applied for by selecting one of the options: NHIS only, Private Scheme only, or Both.
7. Provide the registration details of your company, including the Business Registration Number, date registered, and date of last renewal.
8. Complete the registration section by entering the name of the appropriate regulatory body and the registration number.
9. Fill in the facility address with details such as street address, postal address, town/city, district, region, telephone number, cell phone number, fax number, email, and website.
10. Enter the details of the Chief Executive, Administrator, or Proprietor, including name, position, contact number, institutions attended, and their qualifications.
11. Indicate the services offered by ticking the relevant boxes and specify any other services if applicable.
12. Provide details of the bank account including the banker’s name, branch, account name, and account number.
13. List the key professional staff, indicating the type of professional and the number of each category.
14. Attach the required copies of documents, such as certificates of registration and proof of qualifications as specified.
15. Complete the declaration section by providing your name, position, and signature, confirming the accuracy of the information provided.
16. Finally, review all sections for accuracy, save any changes made, and prepare to download, print, or share the completed application form.

Complete your Nhis Apply Online application process efficiently by following these steps.