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Bio-Medical Waste Management System

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'), the 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)
 


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