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Consent Form

This document is a consent form for an individual to release information to the Pakistan Medical and Dental Council (PM&DC) for verification of their credentials. The individual authorizes PM&DC to obtain verification and necessary information directly from the granting institution. The individual also agrees to pay any fees charged by the institution for verification. Finally, PM&DC is not bound by confidentiality regarding the verification process and information received.

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Sana Shafeeq
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4K views1 page

Consent Form

This document is a consent form for an individual to release information to the Pakistan Medical and Dental Council (PM&DC) for verification of their credentials. The individual authorizes PM&DC to obtain verification and necessary information directly from the granting institution. The individual also agrees to pay any fees charged by the institution for verification. Finally, PM&DC is not bound by confidentiality regarding the verification process and information received.

Uploaded by

Sana Shafeeq
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
  • Disclosure Form

DISCLOSURE FORM

CONSENT TO RELEASE OF INFORMATION

TO THE PAKISTAN MEDICAL AND DENTAL COUNCIL

I…………………………………..………………..(full name) hereby authorize the Pakistan Medical and


Dental (PM&DC), to obtain verification and all necessary information for purposes of
verification of my credentials from the granting institution/authority or any other authority as
the case may be.

I shall directly pay to the institution/authority the fee, if any, that may be charged for
verification by the institution/authority who is requested to provide the verification provider.

The Pakistan Medical and Dental Council is not bound to any confidentiality in respect of
verification and information received by it in pursuance of my request.

SIGNATURE OF APPLICANT/DOCTOR

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