1. Register Account Details2. Onboarding clearance

Healthcare Professional Registration

Submit your professional credentials to request activation on the JSK Telehealth Network and Medikredit routing portals.

SECTION A: DOCTOR PERSONAL DETAILS

Title

First Name

Last Name

Gender

Date of Birth

Mobile Number

Email Address

Physical Address

Postal Code

Province

City

Country

PROFESSIONAL REGISTRATION DETAILS

Medical Council Registration No.

HPCSA Number

Qualification

Specialization

Years of Experience

HPCSA Registration Category

Good Standing with HPCSA?

DOCTOR CATEGORY

Current Employment Status

Doctor Type

PRACTICE DETAILS

Hospital Name (Optional)

Clinic Name (Optional)

Practice Address

CONSULTATION SERVICES & DETAILS

Consultation Type

Available Days

Available Time

Provide Telehealth Consults?

Access to Private Consult Space?

Stable Internet Connection?

Willing to issue digital prescriptions?

Willing to issue digital medical certs?

Short Biography / Bio (Optional)

BANKING DETAILS

Bank Name

Account Holder Name

Account Number

Branch Code

Account Type

DOCUMENT UPLOADS

Upload Credentials Document

Upload proof of HPCSA registration or clinical certification. Allowed types: PDF, DOC, DOCX, JPG, PNG (Max 5MB)

Choose File

LANGUAGE PROFICIENCY

Languages Spoken (comma separated)

DECLARATIONS & POPIA CONSENT

I hereby declare that all information submitted in this profile registration is true, correct, and current, and that I am a medical professional in good standing authorized to practice under the HPCSA.I consent to JSK Healthcare (Pty) Ltd processing my personal details, banking files, and credentials for onboarding verification in compliance with POPIA and HIPAA standards.