Formulir Izin Kesehatan
Formulir Izin Kesehatan
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Formulir Izin Kesehatan
Super Admin 2024-12-23 04:15:41 49014
Pencabutan Izin
| No | Nama Formulir | Formulir |
|---|---|---|
| 1 | Form Pencabutan SIP | Download |
| 2 | Form Pencabutan SIA | Download |
Surat Keterangan
| No | Nama Formulir | Formulir |
|---|---|---|
| 1 | Form permohonan surat keterangan SIP Nakes | Download |
| 2 | Form Permohonan surat keterangan Tempat Praktik | Download |
| 3 | Form Surat Pernyataan Tidak Memiliki SIP | Download |
Rekomendasi Puskesmas
| No | Nama Formulir | Formulir |
|---|---|---|
| 1 | Form Rekomendasi STPT | Download |
| 2 | Folder Rekomendasi Puskesmas/Form Rekomendasi Klinik Pratama | Download |
Non Perizinan
| No | Nama Formulir | Formulir |
|---|---|---|
| 1 | Permohonan Laik Sehat Hotel | Download |
| 2 | Permohonan Laik Hygiene Restoran-Rumah makan | Download |
| 3 | Permohonan Toko Alkes | Download |
| 4 | Permohonan Surat Izin Tukang Gigi | Download |
| 5 | Permohonan STPT | Download |
| 6 | Permohonan SP PIRT | Download |
| 7 | Permohonan PKRT | Download |
| 8 | Permohonan Laik Hygiene Jasaboga | Download |
Nakes Mandiri
| No | Nama Formulir | Formulir |
|---|---|---|
| 1 | SIP Terapis Wicara Mandiri | Download |
| 2 | SIP Terapis Gigi dan Mulut Mandiri | Download |
| 3 | SIP Tenaga Gizi Mandiri | Download |
| 4 | SIP Psikologi Klinis Mandiri | Download |
| 5 | SIP Perawat Mandiri | Download |
| 6 | SIP Ortotis Protetis Mandiri | Download |
| 7 | SIP Okupasi Terapi Mandiri | Download |
| 8 | SIP Fisioterapi Mandiri | Download |
| 9 | SIP Dokter Umum Mandiri | Download |
| 10 | SIP Dokter Spesialis Mandiri | Download |
| 11 | SIP Dokter Gigi Spesialis Mandiri | Download |
| 12 | SIP Dokter Gigi Mandiri | Download |
| 13 | SIP Bidan Mandiri | Download |
| 14 | Surat Keterangan Tempat Praktek Mandiri | Download |
Nakes Di Faskes
| No | Nama Formulir | Formulir |
|---|---|---|
| 1 | SIP Tenaga Sanitarian Faskes | Download |
| 2 | SIP Perekam Medis Faskes | Download |
| 3 | SIP TTK Faskes | Download |
| 4 | SIP Terapis Wicara Faskes | Download |
| 5 | SIP Terapis Gigi dan Mulut Faskes | Download |
| 6 | SIP Tenaga Gizi Faskes | Download |
| 7 | SIP Teknisi Kardiovaskuler Faskes | Download |
| 8 | SIP Teknisi Gigi Faskes | Download |
| 9 | SIP Refraksionis Optisien Faskes | Download |
| 10 | SIP Radiografer Faskes | Download |
| 11 | SIP Psikologi Klinis Faskes | Download |
| 12 | SIP PPDS | Download |
| 13 | SIP PPDGS | Download |
| 14 | SIP Perawat Faskes | Download |
| 15 | SIP Penata Anestesi Faskes | Download |
| 16 | SIP Ortotis Protetis Faskes | Download |
| 17 | SIP Optometris Faskes | Download |
| 18 | SIP Okupasi Terapi Faskes | Download |
| 19 | SIP Fisioterapi Faskes | Download |
| 20 | SIP Elektromedik Faskes | Download |
| 21 | SIP Dokter Umum Faskes | Download |
| 22 | SIP Dokter Spesialis Faskes | Download |
| 23 | SIP Dokter Gigi Spesialis Faskes | Download |
| 24 | SIP Dokter Gigi Faskes | Download |
| 25 | SIP Bidan Faskes | Download |
| 26 | SIP-ATLM Faskes | Download |
| 27 | SIP Apoteker Fasilitas Produksi | Download |
| 28 | SIP Apoteker Fasilitas Pelayanan | Download |
| 29 | SIP Apoteker Fasilitas Distribusi | Download |
| 30 | Surat Keterangan Tempat Praktik | Download |
Faskes
| No | Nama Formulir | Formulir |
|---|---|---|
| 1 | Permohonan SIA Pindah Lokasi | Download |
| 2 | Permohonan SIA Ganti Apoteker | Download |
| 3 | Permohonan SIA Baru | Download |
| 4 | Permohonan PEO-Toko Obat | Download |
| 5 | Permohonan Optik | Download |
| 6 | Izin Operasional Klinik Pratama | Download |