GF Payment Test This is an online payment portal that enables the tracking and administration of registration fees for regulated health professionals. The online payment portal should only be used after your registration application has been submitted. Registration fees are non-refundable. For questions or concerns about the billing and payer information form, contact the Registrations & Licensing Team via professions@healthcouncil.bmBilling/Payer InformationThis section must be completed with details of the person whose name is on the debit/credit card being used to pay the registration fee.Payer Name(Required) First Name Last Name Address(Required) Address City Parish Zip/Postal Code Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Email(Required) Phone(Required)Applicant InformationThis section must be completed with the details of the individual who is applying for registration. If you are applying for renewal and your profession is not listed, please submit your renewal via bermuda.mapay.comNumber of Applicants(Required)12345678910Applicant 1Applicant Name(Required) First Name Middle Name Last Name Type of Application(Required) New Renewal Locum Tenens Visiting Practitioner Status Change Other Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Optometrist & Opticians Practicing Pharmacist Psychologist Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Profession Type(Required) Dental Practitioners Optometrist & Opticians Psychologist Profession Type(Required) Dental Practitioners Psychologist Profession Type(Required) Status Change to Practicing (within 1 year of registering) Profession Type(Required) Request for Certificate of Professional Standing (COPS) Request for Registration Certificate (Hardcopy) Renewal Late Fee Include Renewal Late Fee ($50) Renewal Late Fee Include Renewal Late Fee ($140) Renewal Late Fee Include Renewal Late Fee ($60) Fee amount per applicantThis includes the renewal late fee, if applicable.Applicant 2Applicant Name(Required) First Name Middle Name Last Name Type of Application(Required) New Renewal Locum Tenens Visiting Practitioner Status Change Other Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Optometrist & Opticians Practicing Pharmacist Psychologist Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Profession Type(Required) Dental Practitioners Optometrist & Opticians Psychologist Profession Type(Required) Dental Practitioners Psychologist Profession Type(Required) Status Change to Practicing (within 1 year of registering) Profession Type(Required) Request for Certificate of Professional Standing (COPS) Request for Registration Certificate (Hardcopy) Renewal Late Fee Include Renewal Late Fee ($50) Renewal Late Fee Include Renewal Late Fee ($140) Renewal Late Fee Include Renewal Late Fee ($60) Fee amount per applicantThis includes the renewal late fee, if applicable.Applicant 3Applicant Name(Required) First Name Middle Name Last Name Type of Application(Required) New Renewal Locum Tenens Visiting Practitioner Status Change Other Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Optometrist & Opticians Practicing Pharmacist Psychologist Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Profession Type(Required) Dental Practitioners Optometrist & Opticians Psychologist Profession Type(Required) Dental Practitioners Psychologist Profession Type(Required) Status Change to Practicing (within 1 year of registering) Profession Type(Required) Request for Certificate of Professional Standing (COPS) Request for Registration Certificate (Hardcopy) Renewal Late Fee Include Renewal Late Fee ($50) Renewal Late Fee Include Renewal Late Fee ($140) Renewal Late Fee Include Renewal Late Fee ($60) Fee amount per applicantThis includes the renewal late fee, if applicable.Applicant 4Applicant Name(Required) First Name Middle Name Last Name Type of Application(Required) New Renewal Locum Tenens Visiting Practitioner Status Change Other Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Optometrist & Opticians Practicing Pharmacist Psychologist Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Profession Type(Required) Dental Practitioners Optometrist & Opticians Psychologist Profession Type(Required) Dental Practitioners Psychologist Profession Type(Required) Status Change to Practicing (within 1 year of registering) Profession Type(Required) Request for Certificate of Professional Standing (COPS) Request for Registration Certificate (Hardcopy) Renewal Late Fee Include Renewal Late Fee ($50) Renewal Late Fee Include Renewal Late Fee ($140) Renewal Late Fee Include Renewal Late Fee ($60) Fee amount per applicantThis includes the renewal late fee, if applicable.Applicant 5Applicant Name(Required) First Name Middle Name Last Name Type of Application(Required) New Renewal Locum Tenens Visiting Practitioner Status Change Other Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Optometrist & Opticians Practicing Pharmacist Psychologist Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Profession Type(Required) Dental Practitioners Optometrist & Opticians Psychologist Profession Type(Required) Dental Practitioners Psychologist Profession Type(Required) Status Change to Practicing (within 1 year of registering) Profession Type(Required) Request for Certificate of Professional Standing (COPS) Request for Registration Certificate (Hardcopy) Renewal Late Fee Include Renewal Late Fee ($50) Renewal Late Fee Include Renewal Late Fee ($140) Renewal Late Fee Include Renewal Late Fee ($60) Fee amount per applicantThis includes the renewal late fee, if applicable.Applicant 6Applicant Name(Required) First Name Middle Name Last Name Type of Application(Required) New Renewal Locum Tenens Visiting Practitioner Status Change Other Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Optometrist & Opticians Practicing Pharmacist Psychologist Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Profession Type(Required) Dental Practitioners Optometrist & Opticians Psychologist Profession Type(Required) Dental Practitioners Psychologist Profession Type(Required) Status Change to Practicing (within 1 year of registering) Profession Type(Required) Request for Certificate of Professional Standing (COPS) Request for Registration Certificate (Hardcopy) Renewal Late Fee Include Renewal Late Fee ($50) Renewal Late Fee Include Renewal Late Fee ($140) Renewal Late Fee Include Renewal Late Fee ($60) Fee amount per applicantThis includes the renewal late fee, if applicable.Applicant 7Applicant Name(Required) First Name Middle Name Last Name Type of Application(Required) New Renewal Locum Tenens Visiting Practitioner Status Change Other Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Optometrist & Opticians Practicing Pharmacist Psychologist Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Profession Type(Required) Dental Practitioners Optometrist & Opticians Psychologist Profession Type(Required) Dental Practitioners Psychologist Profession Type(Required) Status Change to Practicing (within 1 year of registering) Profession Type(Required) Request for Certificate of Professional Standing (COPS) Request for Registration Certificate (Hardcopy) Renewal Late Fee Include Renewal Late Fee ($50) Renewal Late Fee Include Renewal Late Fee ($140) Renewal Late Fee Include Renewal Late Fee ($60) Fee amount per applicantThis includes the renewal late fee, if applicable.Applicant 8Applicant Name(Required) First Name Middle Name Last Name Type of Application(Required) New Renewal Locum Tenens Visiting Practitioner Status Change Other Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Optometrist & Opticians Practicing Pharmacist Psychologist Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Profession Type(Required) Dental Practitioners Optometrist & Opticians Psychologist Profession Type(Required) Dental Practitioners Psychologist Profession Type(Required) Status Change to Practicing (within 1 year of registering) Profession Type(Required) Request for Certificate of Professional Standing (COPS) Request for Registration Certificate (Hardcopy) Renewal Late Fee Include Renewal Late Fee ($50) Renewal Late Fee Include Renewal Late Fee ($140) Renewal Late Fee Include Renewal Late Fee ($60) Fee amount per applicantThis includes the renewal late fee, if applicable.Applicant 9Applicant Name(Required) First Name Middle Name Last Name Type of Application(Required) New Renewal Locum Tenens Visiting Practitioner Status Change Other Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Optometrist & Opticians Practicing Pharmacist Psychologist Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Profession Type(Required) Dental Practitioners Optometrist & Opticians Psychologist Profession Type(Required) Dental Practitioners Psychologist Profession Type(Required) Status Change to Practicing (within 1 year of registering) Profession Type(Required) Request for Certificate of Professional Standing (COPS) Request for Registration Certificate (Hardcopy) Renewal Late Fee Include Renewal Late Fee ($50) Renewal Late Fee Include Renewal Late Fee ($140) Renewal Late Fee Include Renewal Late Fee ($60) Fee amount per applicantThis includes the renewal late fee, if applicable.Applicant 10Applicant Name(Required) First Name Middle Name Last Name Type of Application(Required) New Renewal Locum Tenens Visiting Practitioner Status Change Other Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Optometrist & Opticians Practicing Pharmacist Psychologist Profession Type(Required) Allied Health Professionals Dental Practitioners Dental Hygienist & Dental Technicians Profession Type(Required) Dental Practitioners Optometrist & Opticians Psychologist Profession Type(Required) Dental Practitioners Psychologist Profession Type(Required) Status Change to Practicing (within 1 year of registering) Profession Type(Required) Request for Certificate of Professional Standing (COPS) Request for Registration Certificate (Hardcopy) Renewal Late Fee Include Renewal Late Fee ($50) Renewal Late Fee Include Renewal Late Fee ($140) Renewal Late Fee Include Renewal Late Fee ($60) Fee amount per applicantThis includes the renewal late fee, if applicable.PaymentReview your fees and complete payment. 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