New Registration

Category Select Category Category E - Medical Students Category D - Special category by written application and subject to board approval Category C - Interns / Volunteers / Retired Members / Members currently not working in Namibia Category B - Private Medical Practitioners Category A - Public Services (State) Practitioners D B C A 1

Title Dr. Prof.

Initials

Surname

First Name

Preferred Name

Practice Name

Email

Tel

Mobile

Fax

Specialization Select Specialization General Practitioner Family Physician Paediatrician Surgeon Internal Medicine Psychiatrist Ophthalmologist Gynaecologist Cardiologist Rheumatologist Dermatologist Neurologist Neurosurgeon Radiologist Orthopaedic Surgeon Nephrology Endocrinology Plastic and Reconstructive Surgeon Oncology Other Gastro-Enterologist ENT Surgeon Pathologist Psychologist Anaesthetist Urologist Radiation Oncologist Pulmonologist Physician Specialist

Postal Address

PO Box/Private Bag

Suburb

City/Town Select Aranos Eenhana Gobabis Grootfontein Karasburg Karibib Katima Mulilo Keetmanshoop Khorixas Luderitz Mariental Okahandja Omaruru Ondangwa Ongwediva Opuwo Oranjemund Oshakati Otavi Otjiwarongo Outapi Outjo Rehoboth Rundu Swakopmund Tsumeb Usakos Walvis Bay Windhoek

Country

Postal code

Physical Address

Physical Address

Town/Suburb

Registration Nr's

HPCNA Nr

HPCSA Nr

Qualifications

Qualification	Institution	Year

Specialization/Professional Interests & Special Practice Interest

 

Membership Benefits

Member benefits and services

1. Unrestricted Access To The Information MAN Has To Offer
2. Representation For Individuals And Groups In All Matters Affecting The Profession
3. Industrial Relations Advice, Support And Representation
4. Private Practice Support, Advice And Coding Support Services
5. Continuing Professional Development Services, Including Access To Advice, Information, Recording Systems And Point-Earning Opportunities
6. Ability To Communicate With Entire Membership Base With Regards To Locum Requests/Offerings, And Practice/Partnership Opportunities.