Register as a doctor



Physician registration
Please enter your details. Fields marked with a * are required.

Choose a username: *
Password: *
Retype password: *
Title:
First name: *
Last name: *
I am a: *
Date of birth: *
Personal address:
Country:
Personal phone:
Personal phone (a/h):
Personal fax:
Practice name:
Practice address:
Practice phone:
Practice fax:
E-mail address: *
Confirm e-mail address: *
Professional registration no.: * Please enter your Health Professions Council of South Africa number. If you are a physician registered in another country, please select "Other" and enter your professional registration number.
HPCSA    
BHF    
Other    

664601
Please type the numbers you see above into the box below. *
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