Certificate Request 1Access2Requester Details3Event Details4Certificate details Application ReferenceEnter Access Code* Validation Requester DetailsRequester name* Department*Please SelectClinical Audit & Control DeptClinical Governance Committees OfficeCorporate Communication & Marketing DeptCorporate Environmental Health & Safety DeptCorporate Performance Management DeptCorporate Quality & Excellence DeptCorporate Shared Support Services Sector CEO OfficeCustomers Happiness DeptData Analysis, Research & Studies DeptDirectorate - Director General OfficeDirectorate - Information Security OfficeDirectorate - Shaikh Palaces Nursing ServicesDubai Health Insurance Corporation CEO OfficeFinancial Affairs DeptGeneral Medical Committee OfficeGeneral Services & Admin Affairs DeptGovt Insurance Programs Management DeptHealth Economics & Ins Policies DeptHealth Informatics & Smart Health DeptHealth Innovation CenterHealth Insurance Providers Permits DeptHealth Licensing DeptHealth Policies & Standards DeptHealth Regulation Sector CEO OfficeHealth Tourism DeptHuman Resources DeptInformation Technology DeptInternal Audit DeptInvestment & PPPs DeptIT DepartmentLegal Affairs DeptMedical Education & Research DeptOverseas Medical Treatment DeptPharmacy DeptPublic Health Protection DepartmentPurchasing & Contracting DeptRisk Management OfficeStrategy & Corporate Development Sector CEO OfficeStrategy & Governance DeptVIP ClinicOtherDepartment Name* Email* Contact Number* Event DetailsEvent Title* Event Organized by:*Please SelectClinical Audit & Control DeptClinical Governance Committees OfficeCorporate Communication & Marketing DeptCorporate Environmental Health & Safety DeptCorporate Performance Management DeptCorporate Quality & Excellence DeptCorporate Shared Support Services Sector CEO OfficeCustomers Happiness DeptData Analysis, Research & Studies DeptDirectorate - Director General OfficeDirectorate - Information Security OfficeDirectorate - Shaikh Palaces Nursing ServicesDubai Health Insurance Corporation CEO OfficeFinancial Affairs DeptGeneral Medical Committee OfficeGeneral Services & Admin Affairs DeptGovt Insurance Programs Management DeptHealth Economics & Ins Policies DeptHealth Informatics & Smart Health DeptHealth Innovation CenterHealth Insurance Providers Permits DeptHealth Licensing DeptHealth Policies & Standards DeptHealth Regulation Sector CEO OfficeHealth Tourism DeptHuman Resources DeptInformation Technology DeptInternal Audit DeptInvestment & PPPs DeptIT DepartmentLegal Affairs DeptMedical Education & Research DeptOverseas Medical Treatment DeptPharmacy DeptPublic Health Protection DepartmentPurchasing & Contracting DeptRisk Management OfficeStrategy & Corporate Development Sector CEO OfficeStrategy & Governance DeptVIP ClinicOtherDepartment Name* Event Start Date* DD slash MM slash YYYY Event End Date* DD slash MM slash YYYY Event Type* Physical Online Venue*Please SelectDHA VenueNon DHA VenueCME Accreditted ?* Yes No Accreditation Number* Eg : DHA/MTS/ACC/xx-xxxx/AUpload Accreditation Letter*Accepted file types: pdf, Max. file size: 1 MB. Certificate DetailsAdditoinal Signature Required* Yes No Standard Certificate have 1 signature from MERD. IF you required an additional signature form your department, please select YesSignatury Details* Full Name Position Department Upload e-signature*Accepted file types: pdf, jpg, jpeg, png, Max. file size: 1 MB.Email Certificates ?* Yes No If you require email the certificate directly to participants emails, please choose yesEmail Body*Write email content of particiapnt certificate email.Upload Participants ListAteendees List Upload*Accepted file types: xls, xlsx, Max. file size: 1 MB.Upload participants list in excel format Download SampleCAPTCHANameThis field is for validation purposes and should be left unchanged.