DOWNLOADS

Download forms from the links below:

Health Facilities Inspection Checklists

  1. Level 2
  2. Level 3A
  3. Level 3B
  4. Level 4A
  5. Level 4B
  6. Level 5A
  7. Level 5B
  8. Level 6A
  9. Level 6B

Ambulance Checklist

Health Facility and Medical Camps Application & Notification Forms

    1. Requirements for Opening a Health Institution
    2. Application for Registration of Private Medical or Dental Institution (NEW)
    3. Facility Closure Notification Form
    4. Application to conduct a Medical or Dental Camp
    5. Request for Change of Particulars for Health Institution Application Form

Internship

  1. Application for Indexing of Medical & Dental students
  2. Application for Medical or Dental Internship License
  3. Verification of Completion of Medical Internship Training
  4. Verification of Completion of Dental Internship Training
  5. Application for COHO Internship License

Examination & Peer Review Forms

  1. Application for Internship Qualifying Examination
  2. Application for Pre-registration examination for Foreign trained doctors
  3. Application for Peer Review Exam

KMPDC Feedback Forms

  1. Acknowledgement of Receipt of Registration Certificate
  2. Appeals Register Form
  3. Application For Lodging a Complaint
  4. Customer Satisfaction Survey Form
  5. Examination Feedback Form
  6. Examiners Monitoring and Evaluation Form
  7. Public Stakeholder Feedback Form

Practitioner Forms

  1. Application_For_Permanent_registration_as_a_Medical_or_Dental_Practitioner
  2. Application for Medical Dental Practitioners Reciprocal Registration Recognition under East Africa Community Protocol
  3. Application for Recognition of Specialty/ Sub-specialty Status
  4. Specialist Referee Request Form
  5. Application for Certificate of Status
  6. Application_for_Oral_Health_Practitioner_Internship_License
  7. Temporary registration as a Medical or a Dental Practitioner
  8. Application For Temporary Licence For Foreign Trained Medical/Dental Students (Elective)
  9. Application_Permanent_registration_as_a_Oral_Health_Practitioner
  10. Medical Attestation Certification Application Guide

CPD Forms

  1. Application for New Accreditation as a CPD Provider
  2. Application for Renewal of CPD Accreditation

Medical Management Referral Form (Abroad)

  1. Referral Form for Medical Management Abroad

Other Forms

  1. Application for Lodging a Complaint
  2. Medical Practitioners and Dentists (Forms and Fees)(Amendment) Rules 2012
  3. Application for Registration as a Virtual Medical Services Provider
  4. Application for API endpoint (integration)

Emegency Service Providers

  1. Public Notice on Registration of Ambulances Transitioning to Online Platform.
  2. Application for Authority to Practice as EMS personnel
  3. Ambulance Owner Registration Guide
  4. Emergency Medical Practitioner Registration Guide