Apply for accreditation

Submit an application

Full name of medical organizations (taking into account the form of ownership) *

First head of medical organization *

Full name

Desired date of accreditation *

Attention* The date shown is not final. The final date for the accreditation survey is determined by the accrediting body.

Information about the organization

Region *

City *

Business identification number (BIN) *

Type of ownership *

Year of creation (from a certificate of state registration) *

According to the Accreditation policy, the organization must function for at least 12 months

Number, date of issue, series of the license for medical activities and (or) pharmaceutical activities *

Certificate of state (accounting) registration *

(Re-registration, certificate) - number, series, by whom and when issued, status of a legal entity)

Checking account *

Account number, name and location of the bank

Medical activity type *

List the types, profiles of services provided

Organizational structure

Including structural divisions located in a separate building, branches, representative offices and facilities. It is necessary to list the subdivisions, including those located in a separate building, indicating the capacity, location and banking details

List the divisions, including those located in a separate building, indicating the capacity, location and banking details *

1) the number of hospital beds: ___ beds and / or the capacity of the outpatient organization / unit (visits per shift) 2) the number of attached population ____; 3) the average number of patients treated during 12 months in the hospital, and (or) visits to the clinic within 12 months; 4) the total number of staff: __, of which employed: __, vacant: __ 5) list outsourced / subcontracted services organizations:________________________________________

Responsible person for filling out self-assessment

Surname, name, IIN, position Contact phone number and email address

Name *

First

Last

IIN *

Position *

Phone number *

Mobile

Personal email *

Confirm Email

Email of medical organization *

Confirm Email

Medical organization's address

Full address of medical organization *

Postcode *

Website / URL

Facebook *

Instagram *

Documents to upload

Organizational chart (current)

Click or drag a file to this area to upload.

In the form of a diagram (approved in PDF version)

Staffing table

Click or drag files to this area to upload. You can upload up to 15 files.

Approved in PDF version

Certificate of state registration in two languages from the eGov portal as of today (in Russian and Kazakh)

Click or drag files to this area to upload. You can upload up to 2 files.

PDF

Constitution of medical organization

Click or drag files to this area to upload. You can upload up to 2 files.

PDF

State license for medical activity and on the pharm. activities with all applications from the egov portal

Click or drag files to this area to upload. You can upload up to 15 files.

In one PDF file

Presentation

Click or drag files to this area to upload. You can upload up to 11 files.

General presentation on the activities of your organizations or final / annual report (in ppt format)

Signature

Name