Facility On Boarding Form For Controlled Medication Platform
Section A: Regulatory & Facility Related Details
We do not store this information, we will only use it to verify your facility.
your regulatory username and password are the credentials which you use for accessing eclaimlink or shafafiya.
Single Facility Group Facility
If you are a member of a facility group please add all facility licenses from your group in the comment section below.
For example F0002,F0003,F0004
facility license number must be in the exact same format issued by the regulator.
Section B: Facility HIS (Health Information System) Details.
Yes No
Section C: Requester Details.