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Function: require_once

Dinas Kesehatan Kota Semarang

Pelayanan Perijinan Tenaga Kesehatan

2019-12-04 04:34:38

PERMOHONAN SURAT IJIN PRAKTIK (SIP) DOKTER SPESIALIS/DOKTER GIGI SPESIALIS

 

N0

PERSYARATAN

1

Permohonan Surat Izin Praktek (SIP) Ditujukan Kepada

Kepala Dinas Kesehatan Kota Semarang

2

Fotocopy STR yang diterbitkan dan dilegalisasi asli oleh KKI

3

Surat pernyataan mempunyai tempat praktek atau surat

Keterangan dari fasilitas pelayanan kesehatan sebagai tempat prakteknya diatas materai Rp. 6000,-

4

Surat rekomendasi dari organisasi profesi, sesuai tempat praktek

5

Surat Persetujuan dari perhimpunan dokter spesialis (bagi dokter berijazah spesialis)

6

Pas foto berwarna ukuran 4 X 6 sesuai jumlah SIP yang diajukan

7

Surat persetujuan dari atasan langsung bagi Dokter dan Dokter Gigi yang bekerja pada instansi/fasilitas pelayanan kesehatan pemerintah yang akan bekerja di fasilitas Pelayanan Kesehatan swasta secara purnawaktu

8

Fotocopy KTP yang masih berlaku / Surat keterangan Domisili dari Kelurahan

9

SIP asli yang habis masa berlaku untuk perpanjangan SIP atau fotocopy SIP yang sudah dimiliki

10

Surat keterangan pengurusan STR dari Organisasi Profesi (OP) IDI / PDGI

 

 

 

 

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