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Doha, Qatar

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Doctor Information Form

Please take your time and answer ALL of the questions. Thanks

General Info

Medical Center Name:

Doctor Name:

Specialty:

Email:

Tel:

Clinic/Department Name:

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Experiences:










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Professional Memberships:










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Doctor Timetable:

Full day hours

Please tick the dates that apply to you.

From:
To:

&

From:
To:

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Half day hours

Please tick the dates that apply to you.

From:
To:

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Official links & files

Doctor Video link:

(if available)

Doctor Photo

Please attach high resolution copy of your photo here only .jpg or .png accepted, max: 6mb

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Other Documents?

You may share with us any additional files here only zip, rar, pdf, doc, docx, ppt, pptx files accepted, max: 12mb

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