Email address * Company Name * SSM / Reg No. * Upload SSM * Company Registration (eg., Form 24, 49) * Business Owner Name * Business Owner Mobile Number * Phone Office * Mobile * Password * Reconfirm Password * Please review your information before submitting. By confirming, you acknowledge that all information provided is accurate and that you consent to NexGen MedSolutions Sdn. Bhd. collecting and processing you data - including uploaded business documents - for verification and account activation purposes, in accordance with the Personal Data Protection Act (PDPA) 2010. I confirm the information above is correct. * Submit for Verification
