Application Form to register
a
Veterinary Facility from which a clinical service is
rendered
IMPORTANT NOTICE:
To ensure that your facility complies with the minimum standards for
facilities it is recommended that you do a self-evaluation of your
clinical facility prior to completion of the application form to register your
facility with Council.
To enable you
to do a self evaluation it is recommended that you complete the facility
inspection form (check list). Kindly refer to the rules relating to minimum
standards for facilities when you do the self-evaluation.
APPLICATION FORM FOR REGISTRATION OF
VETERINARY PRACTICE FACILITY
TO: The Registrar,
Veterinary
Council of Tanzania
P O Box 9152,
DAR ES SALAAM
In accordance with the provision of
section 15 of the Veterinary Act, I/We……………………………………………………………………………………
Of (Postal
address)………….………………………………………………………….
wishing to carry out business of
veterinary practice do hereby apply for registration of practice facility
situated at……………………………………………………………..
The business in so far as concerns the
practice of veterinary surgery will be under the control of
Dr…………………………………………………………………….a Veterinarian –Registration no………………in accordance
with the Act.
I enclose the following documents:
(a)
Certificate of registration as a
Veterinarian
(b)
Certificate(s)of qualification for the
Anima health Assistants (Para veterinarians)
(c)
A legal contract between me (owner) and
Dr……………………………………(in-charge of the veterinary practice facility)
(d)
Receipt for application fee (Tshs
5,000/=) non-refundable.
NB: Any
change of Veterinarian under whose control the business is carried on, whether
temporary or permanent must be notified to the Registrar immediately.
Applicant’s Signature……………………. Date……………………
Certified by: District Veterinary
Officer for……………………
Name………………………………………………………
Signature………………………… Date…………………