HPCSA Registration Form

Title*

First Name*

Last Name*

E-mail Address*

Confirm E-mail Address*

Phone Number

Password*

Confirm Password*

Confirm Professional Council Registered with*

Profession*

Select Biokineticist profession*

Select Clinical Technologist profession*

Select Counsellor profession*

Select Dental profession*

Select Electro Encephalographic Technician (EE) profession*

Select Emergency Care profession*

Select Environmental Health profession*

Select Hearing Aid Acoustician profession*

Select Laboratory Assistant (LA) profession*

Select Medical Laboratory Scientist (MLS) profession*

Select Medical Orthotics and Prosthetics profession*

Select Medical Technician (GT) profession*

Select Medical Technician (Supplementary) - SGT profession*

Select Medical Technologist (MT) profession*

Select Nutritionist profession*

Select Occupational Specialist profession*

Select Optometrist profession*

Select Paediatric profession*

Select Physician profession*

Select Physiotherapist profession*

Select Psychologist profession*

Select Radiographer profession*

Select Speech Therapist profession*

Select Surgeon profession*

Select Therapist profession*

Professional Council Number*

City*

Guidelines for a strong password:

At least 8 characters—the more characters, the better.
A mixture of both uppercase and lowercase letters and a mixture of letters and numbers.
Inclusion of at least one special character, e.g. ,! @ ? ]#

Only fill in if you are not human

Cookie	Duration	Description
cookielawinfo-checkbox-analytics	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checkbox-functional	11 months	The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checkbox-necessary	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-others	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-performance	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
viewed_cookie_policy	11 months	The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.