How to complete the Application Review Form for Change of Practice Registration

1. Instructions for filling in the form:

1. This form is used for changing the registration of physicians.

2. Fill in with a pen or brush, the content should be specific and true, and the handwriting should be correct and clear.

3. The cover page and Form 1-2 shall be filled in by the applicant, Form 3-5 shall be filled in by the relevant departments, and the code of the new physician's practice certificate on the cover shall be filled in by the registration authority.

4. The code of the new physician's practice certificate that fills in the cover page for changing the practice registration items across provinces, autonomous regions and municipalities directly under the central government.

5. The time, year, month, day and time in the table shall be filled in with Arabic numerals of the Gregorian calendar.

6. To apply for a practice level, please fill in the practice physician or practice assistant physician.

7. To apply for the practice category, please fill in clinical, traditional Chinese medicine, stomatology or public health.

8. The academic qualifications should be filled in with the highest academic qualifications corresponding to the application category.

9. "Photos" are all recent two-inch bareheaded frontal half-length photos.

11. When filling in the employment subjects in the column, the application for clinical and dental categories shall be filled in according to the first-level subjects of the "List of Diagnosis and Treatment Subjects of Medical Institutions"; If you apply for the category of traditional Chinese medicine, fill in the second-level subject of the "List of Diagnosis and Treatment Subjects of Medical Institutions"; If you apply for the public health category, please refer to the occupational classification of public health physicians.

12. If there is a lot of content, you can add additional pages.

2. "Review Form for Application for Change of Practice Registration of Physicians" (template) Name: Doctor's Qualification Level:

Category: Physician Qualification Certificate Code:

Original Physician Practice Certificate Code:

New Physician Practising Certificate Code:

Supervised by the Ministry of Health of the People's Republic of China.

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How to fill in the opinions of the proposed practice institution.

The process for changing the registration of a medical practitioner is as follows:

2. To go through the procedures for the change of licensed physicians, first go to the Medical Administration Department of the Health Bureau to obtain the application form for the change of licensed physicians, and then in accordance with the requirements, the original employing unit and the employing unit shall stamp the official seal of the unit, and then go to the competent health bureau of the original employing unit to go through the change procedures, and after doing so, you can go to the competent health bureau of the employing unit to handle the change registration.

Information to be submitted for handling the requirements: fill in the "Review Form for Application for Change of Practice Registration of Physicians"; ID card (original, B5 copy); Physician Qualification Certificate (original, B5 copy); Practising certificate (original and B5 copy for change of registration); Professional title certificate (original, B5 copy).

The health examination form is included in the "Review Form for Application for Change of Practice Registration of Physicians"; The certificate of proposed employment of the practice institution is included in the "Review Form for Application for Change of Practice Registration of Physicians", (specific specialty, subject or project, etc.); A copy of the "Medical Institution Practice License" of the proposed practice institution and the details of diagnosis and treatment subjects (B5 copy); Other materials.

(Examination registration in other places, change of legal person, etc. shall be handled in accordance with relevant regulations) with the qualification certificate of licensed physicians in other provinces and cities, in principle, it is necessary to register locally, and after the local cancellation is changed, special circumstances shall be handled in accordance with the relevant regulations.

1. Procedures for changing the registration of licensed physicians:

1. If the physician's application for change of practice registration falls under the jurisdiction of the original registration authority, the applicant shall apply to the original registration authority for the change procedures.

2. If the physician's application for change of practice registration does not fall under the jurisdiction of the original registration authority, the applicant shall first apply to the original registration authority for the change of registration items and the code of the physician's practice certificate, and then apply to the registration department of the proposed place of practice to go through the formalities for changing the practice registration.

3. In the case of a change in the practice registration matters across provinces, autonomous regions and municipalities directly under the Central Government, in addition to going through the relevant formalities in accordance with the provisions of the preceding paragraph, the registration department of the new practice location shall withdraw the original "Physician Practice Certificate" and issue a new "Physician Practice Certificate" when going through the practice registration procedures.

2. Materials to be submitted for a licensed physician to apply for registration change:

1. 2 copies of the review form for the application for change of practice registration of physicians (original);

2. 3 one-inch recent bareheaded frontal registration photos;

3. Physician Qualification Certificate (original copy of the original test);

4. Applicant's identity certificate (submit a copy after verification);

5. Physician Practice Certificate;

6. The applicant's health examination form within 6 months issued by the medical institution designated by the registration authority; (Not required in some areas).

7. Proof of proposed employment in medical, preventive and health care institutions;

8. A copy of the "Medical Institution Practice License" of the medical institution to be hired.

9. Other materials and documents required by the registration authority.

The change of registration of the medical practitioner certificate means that after the medical practitioner certificate is issued, it is necessary to change the scope of practice or practice area for some reasons, etc., and it is necessary to bring the relevant materials to the corresponding place of Congpi to apply for registration change.

A licensed physician applying for a change in the scope of practice shall submit the following materials:

1. The application form for changing the scope of practice of physicians uniformly printed by the provincial health administrative department;

2. Physician Qualification Certificate;

3. Physician Practice Certificate;

4. The academic qualifications or training assessment certificates of higher-level graduates corresponding to the scope of practice to be changed are poor;

5. Proof that the employing unit agrees to change the scope of practice;

6. Other materials stipulated by the health administrative department at or above the provincial level.

Precautions. If a physician changes the place of practice, the type of practice, the scope of practice and other registration matters, he or she shall go through the formalities of changing the registration with the competent registration department, and submit the examination form for the application for the change of practice registration of the physician, the "Physician Qualification Certificate", the "Physician Practice Certificate" and other materials required by the health administrative department at or above the provincial level.

However, except for health support for agriculture, consultation, further study, academic exchanges, undertaking tasks assigned by the Ministry of Health, and free clinics approved by the health administrative department approved by medical, preventive and health care institutions.

If a physician's application for change of practice registration falls within the jurisdiction of the original registration authority, the applicant shall apply to the original registration authority for the change.

If a physician's application for a change of practice registration does not fall under the jurisdiction of the original registration authority, the applicant shall first apply to the original registration authority for the change of registration items and the code of the physician's practice certificate, and then apply to the registration department for the practice location of the Pseudo-Min Hall to go through the formalities for changing the practice registration.

Where there is a change in the practice registration matters across provinces, autonomous regions, or municipalities directly under the Central Government, in addition to going through the relevant formalities in accordance with the provisions of the preceding paragraph, the registration department of the new practice location shall withdraw the original "Physician Practice Certificate" and issue a new "Physician Practice Certificate" when going through the practice registration formalities.

The registration authority shall go through the formalities for changing the registration within 30 days from the date of receipt of the application for change of registration. If the applicant is not allowed to change the registration because it does not meet the requirements for changing the registration, the applicant shall be notified in writing within 30 days from the date of receipt of the application for change of registration, and the reasons shall be explained. If the applicant has any objections, he may apply for administrative reconsideration or file a lawsuit with the people's court in accordance with the law.

In the process of changing the registration, a physician shall not engage in practice activities until the original registration items of the "Physician Practice Certificate" have been changed and the new change is approved.

The department in charge of physician practice registration shall establish a statistical system and an archive system for the registration, issuance, cancellation of registration, and modification of registration of the "Physician Practice Certificate".

The local health administrative department at or above the county level shall make a public announcement on the list of persons who have been approved, cancelled or changed to register, and the provincial health administrative department shall summarize it and report it to the Ministry of Health for the record.

Consistent with the initial application, clinical or traditional Chinese medicine, public health, oral and other information needs to be optional.

Fill in the qualification level of physician, licensed physician (or practicing assistant physician), and the category needs to be selected clinical or traditional Chinese medicine, public health, and stomatology. The number of the Physician Qualification Certificate shall be filled in correctly according to the number on the Physician Qualification Certificate. The academic qualifications should be filled in with the highest academic qualifications corresponding to the application category, and the qualifications for professional and technical positions should be filled in as physicians, attending physicians, deputy chief physicians or chief physicians.

If it is a teaching series, such as lecturer, associate professor, professor, please fill in the corresponding attending physician, associate chief physician or chief physician. The time for obtaining the qualification of practicing assistant physician shall be filled in according to the time on the qualification certificate of practicing assistant physician. If you are a licensed physician, this item is not filled.

The time of obtaining the qualification of a medical practitioner shall be filled in according to the time on the "Medical Practitioner Qualification Certificate". If you are a licensed assistant physician, this field is not filled.

A change in the registration form of a medical practitioner requires the consent of the original registration unit and the new work unit to change and register respectively. **There are template prompts above, just fill in according to the requirements of the prompts.

A licensed physician is a person who has a physician's license and its "level" is "licensed physician" and is actually engaged in medical and preventive health care work, excluding licensed physicians who are actually engaged in management work.

Licensed physicians shall have good professional ethics and medical practice standards, carry forward the spirit of humanitarianism, and perform the sacred duties of preventing and curing diseases, saving lives and helping the wounded, and protecting people's health. The whole society should respect doctors. Physicians perform their duties in accordance with the law and are protected by law.