DHA Eligibility Checking Form
Complete the self-assessment to verify your PQR eligibility.
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QUESTION 1: What is your nationality?
Nationality is required.
QUESTION 2: Which category are you applying for?
Select Category...
1. Physician
2. Dentist
3. Nurse
4. Allied Health
5. Traditional Complementary and Alternative Medicine
Category is required.
QUESTION 2.1: Which title are you applying for?
Select Title...
Title is required.
What is your Specialization?
Select Specialization...
Which country is your speciality degree/certificate issued from?
Which specialty degree/certificate do you hold?
When did you receive your speciality certificate?
QUESTION 3: Have you completed your Internship?
YES
NO
Internship Dates (DD/MM/YYYY):
Start Date
End Date
QUESTION 4: Which year did you start and complete this degree?
Start Date
End Date
QUESTION 5: Do you have any related professional experience post completing your education qualifications related to this title?
YES
NO
Which country did you complete this professional experience in?
QUESTION 6: When did you start and complete this experience?
Start Date
End Date
QUESTION 7: Do you want to add another experience?
YES
NO
Second Experience Dates:
Start Date
End Date
QUESTION 8: Have you completed the necessary registration with any professional council or association related to your qualifications after finishing your education?
YES
NO
QUESTION 9: What is the name of your registered council or association?
QUESTION 10: What is your registration date with the council or association?
Summary of Your Application
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