Doctor Application Form

Please fill out the form below to apply to become a part of our team. Ensure that all fields are completed accurately and attach the required documents.

Full Name *

Date of Birth *


Gender *
MaleFemaleOther

Contact Number *

Email Address *

Address *

Professional Information

Educational Qualifications

Payment Information

Attachments

Additional Information (Optional)

Terms & Conditions

By submitting this application, you acknowledge, understand, and agree to the following Terms & Conditions:

• If selected, you will receive an email within 48 hours containing further onboarding instructions and registration requirements.

• Participation may include online consultations, telehealth services, educational activities, training programs, webinars, and/or in-person consultations based on your qualifications, availability, and organizational needs.

• A non-refundable registration and onboarding fee of $12 USD is required to confirm enrollment and initiate the onboarding process.

• All information, credentials, licenses, certifications, identification documents, academic records, and supporting materials submitted to the organization must be authentic, accurate, current, and verifiable.

• The submission, use, creation, modification, possession, or presentation of any fraudulent, forged, altered, fabricated, misleading, or counterfeit document is strictly prohibited. Any individual found providing false documentation or misrepresenting qualifications, experience, certifications, or professional status may be immediately disqualified or terminated without notice and may be reported to relevant authorities, licensing bodies, educational institutions, employers, or regulatory agencies where applicable.

• Selection is not guaranteed. The organization reserves the sole and exclusive right to approve, reject, suspend, restrict, or terminate any application, affiliation, internship, volunteer position, employment opportunity, or professional collaboration at its sole discretion.

• The organization reserves the right to suspend or terminate any participant, member, trainee, volunteer, consultant, or affiliated professional at any time, with or without prior notice, for operational, ethical, legal, compliance, professional, or quality assurance reasons.

• Participants must maintain the highest standards of professional conduct, integrity, ethics, respect, and professionalism in all communications and activities associated with the organization.

• Any form of harassment, discrimination, intimidation, bullying, threatening behavior, abusive language, offensive conduct, inappropriate communication, unprofessional behavior, or misconduct toward patients, clients, staff members, colleagues, management, directors, supervisors, trainers, coordinators, or organizational representatives is strictly prohibited.

• Disrespectful behavior, insubordination, verbal abuse, defamation, public misconduct, inappropriate social media conduct, or the use of offensive language toward senior management, supervisors, directors, trainers, coordinators, or fellow team members will not be tolerated and may result in immediate removal from the organization without prior notice.

• Any involvement in unethical, immoral, illegal, fraudulent, deceptive, or reputation-damaging activities that negatively affect the organization, its patients, clients, staff, reputation, operations, or stakeholders may result in immediate termination and potential legal action.

• All participants are required to maintain strict confidentiality regarding patient information, organizational records, internal communications, training materials, operational procedures, strategic plans, financial information, and proprietary resources.

• Unauthorized disclosure, sharing, copying, distribution, publication, recording, downloading, transfer, or misuse of confidential information, patient information, organizational data, or proprietary materials is strictly prohibited.

• Any breach of confidentiality, privacy, data protection obligations, or organizational policies may result in immediate termination and may subject the individual to civil, criminal, financial, or legal proceedings as permitted by applicable laws.

• The organization reserves the right to pursue legal remedies, including claims for damages, injunctive relief, recovery of losses, and other available legal actions against any individual who causes harm to the organization through misconduct, confidentiality breaches, intellectual property violations, fraud, misrepresentation, or other prohibited activities.

• Participants may not use the organization's name, logo, branding, reputation, trademarks, intellectual property, educational content, projects, programs, business opportunities, patient resources, or professional affiliations for personal benefit or unauthorized activities without prior written approval.

• Organizational projects, educational programs, systems, business models, materials, research, content, training resources, and intellectual property may not be copied, reproduced, distributed, sold, republished, launched, marketed, or utilized through any other organization, institution, company, website, platform, or independent venture without explicit written authorization.

• Misrepresentation of affiliation with the organization or unauthorized use of the organization's identity, credentials, branding, reputation, or professional standing may result in immediate disciplinary action and legal proceedings.

• Within one (1) week of joining, participants must submit a professional biography, profile information, qualifications summary, photograph (if required), and other requested materials for publication on the organization's official website and platforms. Profile content must be prepared and provided by the participant in accordance with organizational standards.

• Attendance at official meetings, orientations, training sessions, compliance briefings, supervision meetings, and other designated organizational activities is mandatory unless formally excused by management.

• Participants are expected to comply with all organizational policies, professional standards, ethical guidelines, confidentiality requirements, and operational procedures at all times.

• Additional responsibilities, obligations, compliance requirements, confidentiality provisions, compensation arrangements, and organizational expectations will be provided through the official Contract Letter and onboarding documentation after profile approval and publication.

• The organization reserves the right to amend, modify, update, interpret, or enforce its policies, procedures, standards, and requirements at any time as deemed necessary.

• Submission of this application constitutes your acknowledgment, understanding, and acceptance of these Terms & Conditions and all applicable organizational policies.