[INFORMATION] Medical Business Licensing Application

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(( Before submitting your application for a medical business license, please ensure you have conducted thorough research into the real-world requirements for the medical profession you aim to portray. This includes, but is not limited to, educational degrees, certifications, work experience, and any specific legal or ethical obligations associated with opening and operating a private practice. Realism in portraying medical professionals is essential and your portrayal should honor the dedication and expertise of real medical professionals. We encourage you to reach out on the LSGOV discord for resources, advice, or clarification whenever needed. ))
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Alessia Thorn
Posts: 187
Joined: Wed Feb 14, 2024 5:55 am
GTA:W Forum Name: tayswiz


https://i.imgur.com/Iyma5DM.png


DEPARTMENT OF HEALTH AND WELFARE
LOS SANTOS CITY GOVERNMENT
CARCER WAY 1, ROCKFORD HILLS, LOS SANTOS, SA





Welcome to the Medical Business Licensing Application process!

We're thrilled that you've decided to embark on this crucial step towards establishing and operating a medical service that adheres to the high standards set forth in the Medical Licensing and Regulation Act. Your dedication to providing quality healthcare services is commendable, and we're here to guide you every step of the way.

This application is designed for all medical personnel, facilities, treatment plans, and other services covered under the Act. Our goal is to make this process as smooth and straightforward as possible, ensuring that you can focus on what you do best—caring for others.
Our dedicated team is here to assist you with any questions or concerns you may have during the application process.
Feel free to reach out to our Medical Director directly any point for support.
Your success and compliance with the Act are our top priorities.
The first step in the process is to fill out the form below and send it to our office here.
Once a member of our team reviews it, your application will be updated and you will receive an e-mail on this government website with next steps.
[+] Medical Business Licensing Application Preview
Image

MEDICAL BUSINESS LICENSING APPLICATION

i. RECEIPT OF APPLICATION FEE
Please submit a payment of $2,500 to the Los Santos City Government Account (Routing No: 020000029) and provide proof of payment below ((screenshot)):
  • i.i Receipt of Payment: ACCESS

I. APPLICANT INFORMATION
  • 1.1 Title: Mr./Mrs./Miss./Dr./Ms.
  • 1.2 Full Name: Answer
    1.3 Date of Birth: DD/MM/YYYY
    1.4 Phone Number: Answer
    1.5 Residential Address: Answer
    1.6 ((GTAW Forum Name)): Answer

II. EDUCATION
  • 2.1 Name of High School: Answer
  • 2.2 Year of graduation: Answer
  • 2.3 Name of College/University (or N/A): Answer
  • 2.4 Year of graduation (or N/A): Answer

III. Practice Information
  • 2.1 Business Name: Answer
  • 2.2 Business Fictitious Name(s): Answer
  • 2.3 Business Address: Answer
  • 2.4 Field of Activities: Answer
  • 2.5 Business Summary: Answer

IV. SHAREHOLDERS
  • Mark with where applicable.

    3.1 Is the applicant in possession of the majority of shares (>50%) of the business?
    Yes
    No
    3.1.1 If selected "No" in the previous question include reasoning (Within the State of San Andreas a Physician must be the 51%+ holder):
    Answer
    3.2 List of Shareholders
    • Full Name Date of Birth Phone Number Number of Shares
      John Doe 01/01/2000 123456789 51
      Sam Sample 02/02/2000 987654321 49
      Answer Answer Answer Answer

V. ADDITIONAL INFORMATION
  • 4.1 Anything else you would like to add?
    Answer

    4.2 Any other employee's requiring licensing?
    Answer




ACKNOWLEDGEMENT & AUTHORIZATION


By submitting this application, I, Full Name, hereby certify that all questions contained in this document were met with truthful statements. I fully authorize the investigation of any content shared on this document. I am aware that lying, omitting, plagiarizing, or maliciously adulterating this application will result in immediate denial and an indefinite ban from applying in the future for business registrations.

[+] Medical Business Licensing Application Format

Code: Select all

[divbox=transparent][center][img]https://i.imgur.com/G9QefZk.png[/img][/center][br][/br][divbox=transparent][center][b][size=250][color=#535a6c]MEDICAL BUSINESS LICENSING APPLICATION[/color][/size][/b]
[/divbox]
[br][/br][color=#535a6c][size=150][b]i. RECEIPT OF APPLICATION FEE[/b][/size][/color][hr][/hr]

Please submit a payment of $2,500 to the Los Santos City Government Account (Routing No: 020000029) and provide proof of payment below ((screenshot)):
[list=none][*][b]i.i Receipt of Payment: [/b] [url=https://URLHERE.com]ACCESS[/url][/list]
[hr][/hr]

[br][/br][color=#535a6c][size=150][b]I. APPLICANT INFORMATION[/b][/size][/color][hr][/hr]

[list=none][*][b]1.1 Title: [/b] Mr./Mrs./Miss./Dr./Ms.
[hr][/hr]
[*][b]1.2 Full Name: [/b] Answer
[hr][/hr]
[b]1.3 Date of Birth: [/b] DD/MM/YYYY
[hr][/hr]
[b]1.4 Phone Number: [/b] Answer
[hr][/hr]
[b]1.5 Residential Address: [/b] Answer
[hr][/hr]
[b]1.6 ((GTAW Forum Name)): [/b] Answer
[hr][/hr][/list]

[br][/br][color=#535a6c][size=150][b]II. EDUCATION[/b][/size][/color][hr][/hr]

[list=none][*] [b]2.1 Name of High School: [/b] Answer
[hr][/hr]
[*] [b]2.2 Year of graduation: [/b] Answer
[hr][/hr]
[*] [b]2.3 Name of College/University (or N/A): [/b] Answer
[hr][/hr]
[*] [b]2.4 Year of graduation (or N/A):[/b] Answer
[hr][/hr][/list]

[br][/br][color=#535a6c][size=150][b]III. Practice Information[/b][/size][/color][hr][/hr]

[list=none][*] [b]2.1 Business Name: [/b] Answer
[hr][/hr]
[*] [b]2.2 Business Fictitious Name(s): [/b] Answer
[hr][/hr]
[*] [b]2.3 Business Address: [/b] Answer
[hr][/hr]
[*] [b]2.4 Field of Activities:[/b] Answer
[hr][/hr]
[*] [b]2.5 Business Summary:[/b] Answer
[hr][/hr][/list]

[br][/br][color=#535a6c][size=150][b]IV. SHAREHOLDERS[/b][/size][/color][hr][/hr]
 [list=none][i]Mark with [cbc][/cbc] where applicable.[/i][br][/br]
[b]3.1 Is the applicant in possession of the majority of shares (>50%) of the business?[/b]
[cb][/cb] Yes 
[cb][/cb] No
[hr][/hr]
[b]3.1.1 If selected "No" in the previous question include reasoning (Within the State of San Andreas a Physician must be the 51%+ holder):[/b]
Answer
[hr][/hr]
[b]3.2 List of Shareholders[/b][br][/br]
 [list=none][table]
[tr]
	[th]Full Name[/th]
	[th]Date of Birth[/th]
	[th]Phone Number[/th]
        [th]Number of Shares[/th]
[/tr]
[tr]
	[td]John Doe[/td]
	[td]01/01/2000[/td]
	[td]123456789[/td]
        [td]51[/td]
[/tr]
[tr]
	[td]Sam Sample[/td]
	[td]02/02/2000[/td]
	[td]987654321[/td]
        [td]49[/td]
[/tr]
[tr]
	[td]Answer[/td]
	[td]Answer[/td]
	[td]Answer[/td]
        [td]Answer[/td]
[/tr]
[/table][/list][/list]

[br][/br][color=#535a6c][size=150][b]V. ADDITIONAL INFORMATION[/b][/size][/color][hr][/hr][list=none]
[b]4.1 Anything else you would like to add? [/b]  
[hr][/hr]Answer

[b]4.2 Any other employee's requiring licensing? [/b]  
[hr][/hr]Answer[/list]



[br][/br][br][/br][accordionfixed=1;ACKNOWLEDGEMENT & AUTHORIZATION]
[br][/br][justify]By submitting this application, I, [b]Full Name[/b], hereby certify that all questions contained in this document were met with truthful statements. I fully authorize the investigation of any content shared on this document. I am aware that lying, omitting, plagiarizing, or maliciously adulterating this application will result in immediate denial and an indefinite ban from applying in the future for business registrations.[/justify]
[br][/br][/accordionfixed]

[br][/br][hr][/hr][/divbox]
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