Hpcsa intern duty certificate: Fill out & sign online

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Click ‘Get Form’ to open the hpcsa form 10 in the editor.
Begin by entering your full name in the 'NAME OF APPLICANT' field. This is essential for identification.
Next, fill in the 'NAME OF ACCREDITED FACILITY' where your internship was completed, followed by your 'POSTAL ADDRESS'.
Provide the 'TITLE, INITIALS AND SURNAME OF CONTACT PERSON' for further communication regarding your application.
In the main clinical domains section, specify the periods you completed training in Medicine, Surgery, Obstetrics and Gynaecology, and Paediatrics. Ensure to include exact dates.
For anaesthesiology, indicate the number of general anaesthetics personally administered and ensure it meets the minimum requirement of 40.
Document any leave taken during your internship under vacation leave, maternity leave, and sick leave sections. Total weeks should be clearly stated.
Finally, ensure all signatures are obtained from relevant authorities and that the official stamp of the hospital is affixed before submission.

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How can I eSign my hpcsa form 12 from Gmail?

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