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New Fee Structure
Health & Supportive Care Institutions
(Read the instructions carefully, before filling up the Online IMAGE Application Form)
Private HCIs
may upload the scanned copies of following to the Online IMAGE Application Form:
1)
Affiliation Fee
(Copy of DD or Screenshot or scanned copy of Online Bank Transfer with UTR or Ref No.)
2)
Terms & Conditions
of IMAGE Services
, put Signature & affix Office Seal on all pages
(available under
"Downloads"
)
3)
Registration Certificate
- self attested
(Medical/Nursing/Paramed Staff in-charge of
BM Waste Segregation
)
4)
Letter of Undertaking
from Segregation In-charge
(available under
"Downloads"
in IMAGE website
)
5)
Photo ID Card
of Segregation in-charge - Self attested
6)
PCB Licence
(if the institution is already authorised by the PCB)
7)
LSGD Licence
(if the institution is already registered with ULBs/LSGDs)
To Remit the
Affiliation Fee through NEFT/RTGS,
the Bank details are as
Account No:
0236053000038771
Account Name:
IMAGE IMA
IFSC Code:
SIBL0000236
Name of Bank:
South Indian Bank
Name of Branch:
Chackai, Thiruvananthapuram
If the Afffiliation Fee is paid through Demand Draft
(
drawn in favour of '
IMAGE IMA'
, payable at '
Thiruvananthapuram
'), t
he Original DD may be sent
to
:
The Hon. Secretary, IMAGE Administrative Office, IMA State Headquarters, Anayara, Thiruvananthapuram-695029
(If the Affiliation Fee Amount is not
credited to the IMAGE and the required documents are not uploaded
;
the affiliation request may get deleted from the online server and the HCI needs to re-apply again)
Govt. HCIs
may upload the scanned copies of following to the Online IMAGE Application Form:
1)
Terms & Conditions
of IMAGE Services
, put Signature & affix Office Seal on all pages
(available under
"Downloads")
2) Proof of
sanctioned bed-strength or facilities (
Copy of the official document)
3)
Letter of Undertaking
from Segregation In-charge
(available under
"Downloads"
in IMAGE website
)
(If the
required documents are not uploaded
; the affiliation request may get deleted from the online server and the HCI needs to re-apply again)
Once you click the
SUBMIT
button,
Application Submission Form
&
IMAGE Terms & Conditions
will be sent to your E-Mail
IMAGE Affiliation process will start only after confirming the documents attached to the online application form
You can track the
status of application
by clicking,"
Request Status
"in the website (
https://imaimage.biz/Request-status
)
Register Now
