Registration Page

Personal Information

Name

First Last

Gender

Male

Female

Birthdate

Phone

Nationality

Email

Address

Country State / Province / Region City Street Address ZIP / Postal Code

Professional Information

Now, let us know about your professional background and qualifications.

Qualifications: List your degrees and certifications (e.g., MD, PhD, Board Certification, etc.).

Country of Medical License

Where is your medical license issued?

Medical License Number:

Please provide your medical license number from your home country.

Medical School/University:

Please provide the name and address of the institution where you earned your medical degree.

University Name:

University Address

Country State / Province / Region City University Address:

Practice Information

Please provide details about your current practice.

Clinic or Hospital Name:

Work Address:

Country State / Province / Region City Clinic Address: ZIP / Postal Code

Document Verification

To verify your credentials, please attach a copy of your registration as a certified doctor in your home country.

Attach your Medical License or Registration Certificate: Please upload a certified copy of your registration or license to practice medicine in your home country. This document should be verified by your country's Ministry of Health and certified by the USA Embassy.

File(Required)

Max. file size: 5 MB.

Accepted File Formats: PDF, JPEG, PNG Maximum File Size: 5 MB

Next Step :

Once you have completed this form and attached the necessary documents, click Next to proceed to the Questionnaire for Certification. This will help us assess your commitment to the values and standards of Premium Doctors.

Premium Doctor Oath

As a certified doctor, I take this oath to always prioritize the well-being of my patients above all else. I commit to providing ethical, compassionate care, putting the needs of each patient at the center of every decision I make.

I pledge to ensure that my patients fully understand their treatment options, including risks and alternatives, and that their choices are respected without pressure or bias. My practice will remain transparent, ethical, and focused on delivering the highest standard of care, regardless of financial gain.

I will stay informed and updated on the latest medical advancements to offer my patients the best possible treatments. I commit to continuous learning and applying the best practices in my field.

In every interaction, I will treat my patients with dignity and respect, ensuring that their individual circumstances are considered and that they receive the care they deserve.

Finally, I vow to create an environment that promotes the physical, emotional, and psychological well-being of all my patients.

I hereby swear that at all times, I will consider the patient first.

DATE

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