Advanced Clinical Care (ACC) Programme for Healthcare Professionals – 2022 Cohort

Complete the form below to register for the Advanced Clinical Care (ACC) Programme for Healthcare Professionals – 2022 Cohort Course.

Please note: only healthcare workers in these categories/job roles can register for this course:

Physician/Medical doctors
Pharmacists
Clinical associates
Nurses
Managers
Other staff supporting the rollout/implementation of ACC

First name

Last name

Nationality

ID number

Passport number

PERSAL/PIN/Employee Number

Add N/A if you don't have a PERSAL/PIN/Employee Number.

Job role/title

Other Job Role

Please select the course you completed

NIMART

Basic HIV

Year completed training

Professional Council

Professional registration number

Add your Professional registration number below or add N/A if you don't have a Professional registration number.

Enter your employer name

Sector

Province

Facility

Type your facility name, if you can't find it, type "Alternative/Other" and add your facility name in the text box below

Other facility

District

Sub district

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