Good afternoon Dr,

Thank you for consulting our unit. As requested, enclosed is a set of checklist for you to establish a
new private clinic.

For your info, there are three stages prior to registration of a new private clinic:

Stage I: Submission of a proposal of establishment of a private clinic

Stage II: Submission of a complete application for registration of private clinic

Stage III: Pre-registration Inspection

In the proposal stage, you are required to submit Borang A(1) (UKAPS/SWK/1/2018) together with
two certified true copies of supporting documents. Once the proposal of establishment approved
(i.e. COMPLETE and COMPLY proposal) by CKAPS JKN Sarawak, CKAPS JKN Sarawak will issue a
supporting letter to the municipal council for next stage of the application (a process of approval of
building plan by the municipal council). The application for approval of building plan to the municipal
council is usually handled by the architect.

For the second stage of your clinic application, you are required to submit the following documents
for UKAPS to issue “Surat Tiada Halangan untuk Pengubahsuaian Klinik”:-

1. Borang A (completed and signed and rubber stamped of the company, if relevant from
Medpcs).

2. Supporting documents as per senarai semak dokumen permohonan klinik perubatan s

wasta (2 certified true copies of each except for Statutory Declaration Documents
signed by Commisioner of Oaths which are required to be original documents).

3. Processing fee RM500.00 made payable to Pengarah Kesihatan Negeri Sarawak (only
banker’s cheque or money order).

4. Letter of approval of building plan from municipal council (2 certified true copies).

5. The building plan approved by municipal council (1 copy).

For the last stage of the application, you are required to submit to CKAPS JKN Sarawak 2 certified
true copies of the amended Occupation Permit issued by the Municipal Council, and also photos of:-

1. Exterior signboard of the clinic showing the name of the clinic

2. Clinic entrance and ramp

3. Reception and dispensary areas (including signage)

4. Waiting area (chairs/benches, organization chart for the clinic showing photos and
designation of staffs, policy statements: staff identification, billing procedures, patient’s
rights and grievance mechanism plan printed on A3-sized or bigger)

5. Consultation room (entrance signage, interior showing consultation table, examination

couch, privacy screen, examination light, film illuminator, clinical sink complete with
backsplash, covered overflow hole, long-handled faucet for hand-free purpose, wall
mounted paper towel dispenser and liquid soap dispenser and other fixtures and furnitures)
 6. Treatment room (entrance signage, interior showing , examination couch, privacy
screen, examination light, film illuminator, emergency resuscitation trolley, twin door
refrigerator, clinical sink complete with backsplash, covered overflow hole, long handled
faucet for hand-free purpose, wall mounted paper towel dispenser and liquid soap dispenser
and other fixtures and furnitures)

7. X-ray room (entrance signage, external warning light, warning for pregnant women
outside the room, displayed “Lesen Tenaga Atom”, if applicable)

8. Sterilisation room (entrance signage, autoclave machine, double compartment sink

complete with backsplash, covered overflow hole – if applicable, long-handled faucet for
hand-free purpose, wall mounted paper towel dispenser and liquid soap dispenser, and
exhaust fan above the autoclave)

9. Janitor’s closet (signage, hooks for mop handle, shelf for cleaning detergents, exhaust
fan if providing floor receptor or deep sink, brooms are not allowed to be used within the
clinic except for toilets or five foot way, brooms to be labelled with area of use)

10. Patient’s toilet (signage, grab bar, bidet sprayer, toilet tissue holder, sink complete with
backsplash, mirror, wall mounted paper towel dispenser and liquid soap dispenser).

11. Documentation: complete written policies based on the Senarai Semak Pelan Lantai

For the internal signages, you are required to use permanent material (laminated papers are not
allowed).

For queries, please call me at 082-473398.

Thank you.

Regards,

Cawangan Kawalan Amalan Perubatan Swasta (CKAPS) JKN Sarawak