Doctor Registration

     If your application will be approved by the Board, you will be classified as an Active Member with voting privileges. You will have access to all relevant materials in our website.

First Name: First Name Required

Last Name: Last Name Required

PRC number:* PRC number is Required

Mobile number:* Mobile number is Required

Speciality:* Speciality is Required

Subspeciality:* Subspeciality is Required

Area of practice (Region or province):* Area of practice (Region or province) is Required

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn’t Match

 

No val Please fix the errors above