Instructions

1. This form is intended for individual healthcare practitioners. These include, but are not limited to, physicians, surgeons, dentists, pharmacists, physician assistants, nurses and other allied health and therapeutic care practitioners.
2. You must answer all the questions where neccessary.
3. At the end of this form, you are required to upload your Identity Card (IC), and Current Year APC.
4. If you have any questions concerning this proposal, please contact us.

You may skip sections below, IF category chosen above has best described your job / category. Otherwise, please declare your % of involvement(s) for us to analyse your risk exposure.