- The undersigned hereby applies for an Accreditation Survey by Malaysian Society for Quality in Health (here in after called MSQH).
- The undersigned agrees to facilitate the surveyors appointed by the MSQH to survey the premises, facilities, organisation and operations, including documentation.
- The undersigned hereby acknowledge to have read the Accreditation Survey Application terms and conditions and agrees to all of them.
- The undersigned certifies that the contents of this application form are true and correct
All fields marked with (*) are required.
Upload file : Only *.pdf is allowed. Maximum size for each file is 10MB.
CREATE LOGIN ID
Create new Login ID to access this system.
I already have Login ID.
APPLICANT
- Login ID:
- Full Name:
FACILITY PROFILE
Contact Person
Customer Informations
FACILITY DETAILS
Please complete the following details so that the MSQH better assess the composition of the survey team and the length of survey required.
and currently has the following number of beds (*please specify number in each type). Please note all beds must be declared. Should there be any changes prior to the survey, contact MSQH as soon as possible.
LIST OF SERVICE STANDARD
MISCELLANEOUS
DECLARATION
Person In Charge / Medical Director
- Date:
- 08/09/2024