Volunteer/Patient Registration
Phone No  
Emirates ID No  
Passport No  
Name of the course  
Course Date (Day/Month/Year)  
Your Interest in the SP Program
Please choose for which program you are interested to become a simulated patient  
Medical history (Please list any current/past medical conditions)  
Please tell us why you are applying to become a simulated patient  
Simulated Patients are needed for physical examinations. Are you comfortable while a healthcare professional examines you?  
During which days and hours are you available?  
Upload Passport/Emirates ID(document attachment – jpeg, pdf, word etc.)  
Note: Please bear in mind that Simulated Patients are hired as needed, based on educational courses that are being conducted at our center. We will contact you as soon as a course appropriate for you arises.