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Name of technology |
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(Nama teknologi) |
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Short description of technology |
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(Penerangan ringkas teknologi) |
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| 3. |
Reason for requesting Health Technology Assessment (HTA)
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(Sebab-sebab Penilaian Teknologi Kesihatan (PTK) dipohon) |
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Issue/problems related to technology |
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(Isu/masalah berkaitan dengan teknologi ini) |
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| 5. |
Size & strength of evidence on this technology (cite key references if available) |
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(Saiz dan kekuatan bukti saintifik atas teknologi - sila nyatakan rujukan-rujukan utama jika ada) |
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| 6. |
Name of applicant |
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(Nama pegawai yang memohon) |
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Designation |
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(Jawatan) |
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| 8. |
Address of work |
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(Alamat bertugas) |
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Telephone (Telefon) |
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Email |
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Attachment for additional file :
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(Lampiran sekiranya ruangan tidak mencukupi) |
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Verification Code: 10ZC55NA9N4
Please key in the verification code |
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(Kod Pengesahan) |
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(Sila masukkan semula kod pengesahan) |
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Note:* Technology refers to drugs, equipment, surgical and medical procedures,
health programmes, organizational and support systems for delivery of healthcare |
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Nota:* Teknologi kesihatan merujuk kepada ubat, peralatan perubatan, prosedur klinikal,
program, organisasi dan sistem sokongan untuk penyampaian perkhidmatan kesihatan |
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For further information please contact :
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Health Technology Assessment Section(MaHTAS) |
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Medical Development Division |
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Level 4, Block E1, Precint 1 |
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Government Office Complex |
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62590 Putrajaya, Malaysia |
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Tel : 0388831229 / 0388831246 |
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Fax : 0388831230 |
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Email : htamalaysia@moh.gov.my |
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Sebarang Pertanyaan dan Maklumbalas Sila Hubungi :
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Cawangan Penilaian Teknologi Kesihatan |
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Bahagian Perkembangan Perubatan |
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Pusat Pentadbiran Kerajaan Persekutuan |
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62590 Putrajaya, Malaysia |
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Tel : 0388831229 / 0388831246 |
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Fax : 0388831230 |
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Email : htamalaysia@moh.gov.my |
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