Protecting the public and
guiding the professions

Registrations

Registration with the HPCSA is a pre-requisite for professional practice and it is also a legal requirement to keep all personal details up to date at all times.

Application forms

Professional Boards are co-ordinating bodies for healthcare practitioners registered with the HPCSA. The respective boards that are established for a specific profession, deal with matters relating to a specific profession.

Additional Qualification
Form 19 - Additional Qualification Download form
Form 19 - Emergency Care Board (EMB) Download form
Form 19 - Medicine, Medical Science & Dentistry Download form
Form 19 ODO - Recognition of Diagnostic Privileges -Optometry and Dispensing Opticians Download form
Form 19 SLH and LIC - Speech Language and Hearing Professions Download form
Form 19 ODO - Recognition of Ocular Therapeutics Download form

                    Application for registration
Form 23 - Application for registration Download form
Form 23 DOH - Dental Therapy and Oral Hygiene Download form
Form 23 EMB - Emergency Care Board (EMB) Download form
Form 23 MT - Medical Technologist Download form
Form 23 MLS - Medical Laboratory Scientists  Download form
Form 23 ODO - Optometry and Dispensing Opticians Download form
Form 23 - Independent Practice Download form
Form 24 - Application for Registration Download form
Form 24 BK - Phyisiotherapy, Podiatry and Biokinetics Download form
Form 24 DA - Aplication for registration as Dental Assistant Download form
Form 24 EMB - Application for registration Emergency Care Download form
Form 24 GC - Application for registration as Genetic Counselor Download form
Form 24 GT - Application for registration as Medical Technician Download form
Form 24 KT - Clinical Technologist Download form
Form 24 KT-G Clinical Technologist Download form
Form 24 LA - Application for registration as Lab Assistant Download form
Form 24 MS - Application for registration as Medical Biological Scientist Download form
Form 24 MT - Application for registration Download form
Form 24 OH - Extended functions Download form
Form 24 OS - Medical Orthotics and Prosthetics  Download form
Form 24 OTT - Occupational Therapy Technician (Supervised) Download form
Form 24 PH - Application for registration as Medical Physicist Download form
Form 24 PMT - Registration as Psychometrist Download form
Form 24 PS - Registration as Psychologist Download form
Form 24 RC - Registration as Registered Consellor Download form
Form 24 TT - Application for registration as Dental Therapist Download form
Form 25 MTB - Intern duty certificate for Medical Technology Download form
Form 27 OS - Intern Duty certificate - Medical Orthotics & Prosthetics Dowload form
Form 27 OB/OSA - Intern duty certificate - Medical Orthotists & Prosthetics Dowload form
Form 27 PSY - Intern duty Certficates for Psychologists Download form
Form 176 EHP - Environmental Health Assistants Download form

Community Service
Form 10 A - Intern duty certificate for Completion of a 2 years Internship training programme Download form
Form 11 A - Medical Practitioner Community Service Download form
Form 14 A - Dentist (DP) to perform Community Service Download form
Form 23 OT - Occupational Therapy, Medical Orthotics & Prosthetics & Arts Therapy Download form
Form 23 SLH - Speech Language and Hearing Professions to perform Community Service Download form
Form 23 DR- Radiography to perform Community Service Download form
Form 23 - To perform Community Service Download form
Form 27 - (Generic) Completion of Community Service Download form

                               Foreign Qualification 
Fom 79 Download form
Form 79 A Download form
Form 165 - (Generic) Radiography and Clinical Technology Download form
Form 176 AT - Registration as an Arts Therapist Download form
Form 176 DOH - Letter of endorsement by the Foreign Workforce Management Programme Download form
Form 176 DT - Foreign Qualified Dietician Download form
Form 176 EHP Download form
Form 176 MDB - ECFMG Download form
Form 176 NT Download form
Form 176 ODO Download form
Form 176 OT Download form
Form 176 Specialists Download form
Form 176 MT - Medical Technologists/ Bsc Graduates Download form
Form 177 DR- Application for registration as Radiographer Download form
Form 177 BKT - Application for registration as Clinical Technologist Download form

                       Independent Registration
Form 11 C -  MDB Download form
Form 23 OT - Occupational Therapy, Medical Orthotics & Prosthetics & Arts Therapy Download form
Form 23 A (SLH) -  Change of Category: Speech Language and Hearing Professions Download form
Form 27 - Certificate of Completion of Community Service Download form
Form 133 - Medical Technology (MT) Application to conduct private practice Download form
Form 189 - Dental Therapist (TT) Download form

Intern Registration
Form 10A MDB - Intern in Medicine Download form
Form 23 MDB - Intern in Medicine SA Qualified Download form
Form 23 MSIN; PHIN and GCIN - Medical Biological Scientist, Medical Physicist and Genetic Counsellor only  Download form
Form 26 A - OS Placement of Intern Download form
Form 26 BKIN - Biokineticist Intern Download form
Form 26 GCIN - Intern Genetic Counselor Download form
Form 26 MSIN - Intern Medical Biological Scientist Download form
Form 26 MTIN - Intern Medical Technologist Download form
Form 26 OSIN - Medical Orthotist and Prosthetist Download form
Form 26 PHIN - Intern Medical Physicist Download form
Form 26 PSIN - Intern Psychologist Download form
Form 26 ATIN - Arts Therapy Intern in Drama Download form
Form 26 A AT - Placement of Arts Therapy Intern in Drama Download form
Form 27 AT - Arts Therapy Intern in Drama Duty Certificate Download form
Form 27 BK - Biokineticist for Intern Duty Certificates Download form
Form 36 GC - Certificate of Intern training (Genetic Counsellor) Download form
Form 36 MS - Certificate of Intern training (Medical Biological Scientist) Download form
Form 36 PH - Certificate of Intern training (Medical Physicist) Download form

Restoration
Form 18 - Application for restoration of name to the register Download form
Form 18 PPB - Physiotherapy, Podiatry and Biokinetics only Download form
Form 18 A - OCP - Occupational Therapy, Medical Orthotics & Prosthetics & Arts Therapy Application for restoration Download form
Form 18 C - OCP - Occupational Therapy, Medical Orthotics & Prosthetics & Arts TherapyUndertaking by Supervisor Download form
Form 18 D - OCP - Occupational Therapy, Medical Orthotics & Prosthetics & Arts Therapy Supervisory report Download form
Form 18 F - OCP - Occupational Therapy, Medical Orthotics & Prosthetics & Arts TherapyPortfolio Download form
Form 18 G - OCP - Occupational Therapy, Medical Orthotics & Prosthetics & Arts Therapy Portfolio marking guide Download form

Specialties/ Sub-Specialties
Form 9 - Application for registration as a Registrar / Sub-speciality Trainee Download form
Form 21 MDB - Specialist/ Subspecialist SA Qualified Download form
Form 21.1 MDB -  Application for registration as a Specialist in terms of board notice 230 of 2015 Download form
Form 57 A - MED Sub- Speciallity SA Qualified - Certificate relating to education and training in subspeciality Download form
Form 57 MDB - Certificate relating to training in specialities & sub specialist Download form
Form 57 MED - Certificate relating to training for specialists who commenced specialists training after 1 January 2011 Download form

Students
Form 8 - Visiting Student (Dental Therapy and Oral Hygene) Download form
Form 8 - Visiting Student, in Supplementary Health Services Download form
Form 8 - Visiting Student (Emergency Care) Download form
Form 8 - Visiting Student (Medical and Dental) Download form
Form 8 - Visiting Student (DNB) Download form
Form 8 - Visiting Student (ODO) Download form
Form 39 - Student Intern - Medical & Dental Professions Board Download form
Form 53 BKS - Biokinteticist in Training Download form
Form 53 DA S- Student Dental Assistant Download form
Form 53 EMB - Emergency Care Board Download form
Form 53 MDB and DOH - Student in Medicine/Dentistry Download form
Form 53 MDB and DOH - Student in Medical Science Download form
Form 53 MDB - Students in Medicine Download form
Form 53 OT S - Re-registration after interruption of Studies- Occupational Therapist Student Download form
Form 53 OTS - Occupational Therapist Student Download form
Form 53 PSS - Psychology Student Download form
Form 53 - All Students excluding MDB, DOH & EMB Download form
Form 53 TT S - Dental Therapist Student Download form
Form 53 TTS - Re-registration after interruption of Studies - Dental Therapist Student Download form
Form 53 GTA/LAS Download form

 

Other forms
Application for Aproval of Mobile Practice - ODO Download form
Form 79 - Application to sit the University Examination Download form
Contact details form - Change of Contact details Download form
Preactioners are advised to use the Prescribed Forms when Children are Involved Download form
Form 2 Consent to social or cultural circumcision Download form
Form 3 Consent to religious circumcision Download form
Form 22 Reporting of abuse or deliberate neglect of child Download form
Form 23 Reporting of abuse or deliberate neglect of a child to the Director General Download form
Form 33 Application for Consent to Medical Treatent or Surgical Operation by Minister Download form
Form 34 Consent to surgical operation by a child Download form

Select the professional board from the list below to obtain information relating to registration application forms