Doctor Signup Signup as a medical practitioner here. PrefixMr.Mrs.Ms.Mx.MissDr.Prof.First Name *Middle NameLast Name *ID/Passport number *Phone Number *Email Address *Practice InformationHPCSA Number *Practice Number *Specialty *Phone Number *Email Address *Street Address *Apartment, suite, etcCity *State/Province *ZIP / Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweWebsiteDo you practice at any Medical Facilities (Hospital, Clinics.etc)? If yes, add them hereAdditional NotesWould you like to register a receptionist?YesNoPrefixMr.Mrs.Ms.Mx.MissDr.Prof.First Name *Middle NameLast Name *ID/Passport Number *Phone Number *Email Address *Consent *By completing this application and clicking "I Agree," you, the undersigned practitioner, acknowledge and agree to the following: 1. Accuracy of Information & Legal Responsibility Verification of Credentials: You certify that all information provided in this application—including your professional qualifications, registration numbers (e.g., HPCSA/SAPC), and practice details—is true, accurate, and complete. Misrepresentation & False Information: You acknowledge that providing false, misleading, or fraudulent information, or the misrepresentation of your professional status, is a serious offence. Such conduct may lead to: Immediate termination of your access to the platform without notice. Reporting to regulatory bodies (such as the HPCSA or SAPC) for unprofessional conduct investigations. Criminal prosecution under the Prevention and Combating of Corrupt Activities Act or the Cybercrimes Act for fraud or forgery. Civil liability for any damages or losses incurred by the platform or third parties as a result of such misrepresentation. 2. Data Privacy & POPIA Compliance Consent to Process: You expressly consent to the processing of your personal and professional information by Chroncare for the purposes of account creation, identity verification, and platform administration. Third-Party Sharing: You agree that your information may be shared with authorized third parties, such as medical schemes or regulatory councils, only when necessary for the performance of the platform's services or as required by law. 3. Withdrawal of Consent You understand that you may withdraw your consent at any time by providing written notice. However, you acknowledge that this will result in the suspension or termination of your account, as the processing of this information is essential to your use of the platform. I have read and understood the terms above and certify that the information provided is correct.Submit