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NUMER Medical
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Driver Application Form
Training Videos
Did you complete the training videos?
Yes, I have completed the training
No, I did not watch the videos
Agent ID
*
Phone
*
First name
*
Last name
*
Birthday
Day
Month
Year
GPTRU Member ID #
Address
Region
Email
*
Driver’s License Number
Ghana Card #
License Plate #
How many years of driving experience do you have?
Do you have an active MTN Mobile Money account in your name?
Yes
No
Please Provide phone number of active MTN Mobile Money Account
Do you have an active Whatsapp account?
Yes
No
SECTION 3: COMPETENCY ATTESTATION I, ________________________, attest that I understand and agree to uphold the following competencies as a Medical Transport Driver: I will respect and protect patient confidentiality.
Yes
No
I understand my role in safely transporting patients, ensuring their comfort and security. I will maintain punctuality and reliability.I will keep my vehicle clean and in proper working condition. I will assist passengers, with mobility issues.
Yes
No
Professional Conduct: I recognize that I represent the healthcare team and will conduct myself professionally. I will wear appropriate attire and maintain personal hygiene. I will handle difficult situations with patience and professionalism.
Yes
No
Vehicle Maintenance & Safety Compliance I will conduct daily vehicle inspections, checking brakes, fuel levels. I will comply with all Ghana DVLA driving regulations and safety protocols. I will respond appropriately to vehicle issues.
Yes
No
I confirm that all information provided in this application is accurate and that I understand my responsibilities as a Medical Transport Driver.
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You will receive a phone call at the number provided, once your application is processed. Phone orientations will be held Mon & Tue 8am-6pm. Contact # 233 592775429
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