Request Account

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Please complete this form to request an account on SURAQSA.

Country

First name

Last name

Organization

Street address

City

Pin code

State

Please select the country from the list to show the rest of the fields. Please enter the address of your institute .

Official Email Address

Please enter your official email address. You will receive all notification mails to this email ID. Kindly add suraqsq@chavi.ai to your sender list to ensure mails are not marked as spam.

Phone Number

Please select the correct country code and enter the phone number. This phone number may be used to contact you in case notifications to email address is not working.

Operational Role

Please select the appropriate organizational role from the list

I have read the Terms and Conditions and agree to adhere to the same.

Disclaimers

SURAQSA is a voluntary consortium of centers who have decided to collaborate and cooperate to enhance patient safety and improve the care process. SURAQSA is not affiliated with the Atomic Energy Regulatory Board of India (AERB) and all collaborating institutes are responsible for fulfilment of any and all regulatory norms as mandated by AERB. We are grateful to AERB for providing India with the regulatory landscape which facilitates safe radiation therapy practice.

Developed & Designed by CHAVI

Request Account

Please complete this form to request an account on SURAQSA.

Acknowledgements

Disclaimers