ANZER Client Registration

Please use this form to sign up for access to our clients section. Once you submit this form we will review it and send you an email once your login has been activated (usually about 24hours).

First Name *
Last Name *
Email *
Username * (used for login)
Organization *	Select... Acropolis Medical Centre Anzer Anzer Mandalay Anzer Thailand ArYu International Hospital Asia Royal Hospital Carlington Community Health Centre CBL Medical Centre Cherry Land Hospital City Hospital Mandalay CMHA TIMMINS CMHA Toronto Cornwall Community Hospital, COTAHEALTH Deep River & District Hospital E Health General Hospital Myanmar Haldimand Norfolk ACTT Team Hamilton ACTT2 Hamilton Harts Hanley Group Hospital and Clinic HAWKESBURY & DISTRICT GENERAL Homewood Health Centre Hsu Pyae Sone Hospital Intercare Hospital Jivaka hospital Kemptville District Hospital Lakeridge ACTT LEC Clinic LEO Healthcare Centre Mandalar Hospital Marianhill Mediland Hospital Mingalar Hospital Mingalar Mon hospital Mittamon Hospital MMPS(MDY) MMPS(YGN) MUSKOKA ALGONQUIN HEALTHCARE Mya Tha Har Hospital Myat Taw Win Hospital Myat Thiri Charity Clinic Myat Wai Xyan Hospital Mandalay Myint Myat Than Lwin Clinic Myitta Oo Hospital Nyein Hospital Mandalay Orillia Soldier’s Memorial OSC Hospital Padamyar Hospital Pathlab Diagnostic Centre Pembroke Regional Hospital PGH-Mental Health Pinecrest Queensway Actt Team Ottawa RENFREW VICTORIA HOSPITAL RMI Hospital Royal Tachileik Hospital Sakura Hospital Salvation Army Shae Saung Hospital Shwe La Min Hospital St. Francis Memorial Hospital St. Joseph's Healthcare Hamilton ST. MICHAEL'S HOSPITAL Sunnybrook Health Science Centre TMCSL UNITY Victoria WEST NIAGARA MENTAL HEALTH TEAM Yee Shin Company Ziwathukha Clinic
Occupation*
Phone*
	Enter the code you see on the picture