Kualiti Alam Sdn Bhd

KUALITI ALAM CUSTOMER PROFILE
Clinical Waste Marketing Department
Ladang Tanah Merah A3 Division
71960 Bukit Pelandok
Negeri Sembilan
Tel : 606-6662000 Fax : 606-6662060

Clinical Waste Agreement

Clinical Waste

Please select this option if you would like to retrieve the document for clinical waste

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Hello,
Welcome to Kualiti Alam’s Clinical Waste registration page.

Please fill in the form below, verify your profile information by clicking “submit” and “confirm button”.
There will be four parts to be filled up ( Customer Profile, Terms and Conditions, Waste Description & Treatment Fees).
All details need to be completed. If any of the fields are not applicable please mark as N/A.
Incomplete registration forms will not be accepted.
Incomplete registration forms will not be accepted.
Should you have any difficulties in filling the form, please refer to the user guide (download here)

Approved registration will be notified via email.

*SF ID:

*Staff ID:

*ROB / ROC No:

*GST Registration No:

*Clinic Serial No - Form B

*Have DOE File No? :

*Company Name:

*Billing Address:

Business Address

Collection Address

*Business Address:

*State:

*City/Town:

*Postal Code:

Same Information

*Clinic Name:

*Collection Address:

*State:

*City/Town:

*Postal Code:

*Tel No:

Fax No:

Invalid value

*Email Address:

Additional Email Address 1:

Invalid value

Additional Email Address 2:

Invalid value

*Company CEO / MD:

*Contact Person:

*NRIC No:

*Contact Number:

*Designation:

*Country :

*Products / Services:

*PBT:

*District:

*Town:

*Phone:

Industry Key:

*User ID:

*Password:

VIEW TERM & CONDITION

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