In terms of section 82(7) of the National Health Act, 2003 (Act No. 61 of 2003) as read together with regulation 19 of the Procedural Regulations pertaining to the Functioning of the Office of Health Standards Compliance and Handling of Complaints by the Ombud (the Regulations), an application for renewal of a certificate must be submitted to the Office, within a period of not more than six months before the expiration of the certificate of compliance. This certificate will be renewed following an inspection as set out in regulation 14, provided that the Office may extend the certification for up to 1 year pending an inspection.

Name of health establishment applying for extension of certification

Address

Name of person in charge

Date of last inspection

Date of certification

Date of expiry of certification

Certificate number

Person in charge of health establishment

(Signature)

Date

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