N NGH Cp giy php hot ng i vi c s khm bnh, cha bnh Knh gi: S Y t tnh ng Thp. Tn c s khm bnh, cha bnh:........................................................................... a im: 2........................................................................................... in thoi:.............................................. Email (nu c): ..................................... Thi gian lm vic hng ngy: ........................................................................... nh km theo theo n ny gm cc giy t sau: 1. Bn sao c chng thc quyt nh thnh lp c s khm bnh, cha bnh; 2. Danh sch ng k hnh ngh khm bnh, cha bnh. 3. Bn sao chng ch hnh ngh ca tt c ngi hnh ngh 3. 4. H s nhn s ca ngi lm vic chuyn mn y t ti c s (din khng phi cp chng ch hnh ngh). 4.1. Bn sao c chng thc vn bng chuyn mn. 4.2. Giy chng nhn sc kho. 4.3. S yu l lch. 5. Bng k khai c s vt cht, thit b y t. 6. Danh mc chuyn mn k thut. 7. Giy chng nhn an ton bc x (i vi c s c lp t my X-quang). 8. Hp ng x l cht thi y t (nu c s khng xy dng h thng x l cht thi y t). 9. iu l t chc v hot ng bnh vin (i vi c s l bnh vin). Knh ngh S Y t thm nh v cp giy php hot ng./. GIM C (K tn v ng du)
1. a danh. 2. a ch c th ca c s khm bnh, cha bnh. 3. Chng ch hnh ngh khng do S Y t ng Thp cp th np bn sao c chng thc.