Professional Information:

Description relative to Professional Information:

Please briefly describe the type of business / profession you are currently engaged in or intend to engage in.

Describe your requirements with regard the approx. total area of a suite or building.

Please provide a history of your past and present experience in the Medical and or Business field. Also provide a history of past projects you or your organisation has successfully implemented which demonstrate your ability to deliver a project of the size and scope.

Please briefly describe how you envisage your project to be carried out and if you have an idea of budget and fit out requirements or ideas.

Are you currently trading in any other location/s. Please give a brief description of this business. Are you seeking to replicate or create new divisions / practices?

Please briefly describe your timeline and when you see your business opening its doors


Please complete the table below and provide the signature of the authorized signatory/representative of your organization.