Provincial Health Facility Registration

Register your hospital, health centre, aid post or community health post so the Provincial Office can plan connectivity for your facility. Every registration is checked before access is given.

This form collects facility and staff contact details only. Never enter patient names, medical records, or any information about people receiving care.

Search for your facility or nearby site

If your facility is already a deployment site, choose it here so your registration is linked. Optional.

Facility name

Type of facility

Operated by

Who runs the facility day to day.

Province

District

Ward or village(optional)

Location

Your location helps us plan kit delivery and satellite installation. You can skip this or type the numbers by hand.

Latitude(optional)

Longitude(optional)

Contact person's full name

Position or title

Mobile number

Format: +675 7123 4567 — or just your 7 or 8 digit local number.

Email address(optional)

Confirm email address

Type your email address again. Pasting is turned off so a typo is caught.

Number of staff(optional)

An estimate is fine.

People served(optional)

Roughly how many people your facility serves.

This facility already has some internet connection

What would connectivity help you do?

0 of 1000 characters. At least 20 characters.

Password

At least 10 characters. A short phrase you can remember works well.

Password strength: weak

Confirm password