Saudi Commission For Health Specialties

Classification and Registration Department

Application Form for Certificate of Good Standing

To be filled by the requester

Name in English (as shown in Passport)

First Name

Middle Name

Third Name

Family Name

Registration No.:

Work Place:

City:

Specialty:

Signature:

Category:

To

English

Certificate Language:

Name in Arabic

be completed by Saudi Board trainees

Name of program:
Joined the program from:

TO

Committee/Council Secretary in (Training department)

Date:

Name:

Signature:

Following required documents

Please enclose the following required documents:

1. Copy of Professional Registration ID.
2. Receipt Fee (300) SR.
For more information please contact us :
Fax: 01/4800800 Ext: 1822
E-mail: otb@scfhs.org

otb@scfhs.org