As the owner of the practice submitting this registration application.
There seems to be an error in the answers you provided
Details of person responsible for account related enquiries:
Contact Person at the Accounts Department:
PRACTICE PHYSICAL ADDRESS
This is the address where clients / patients can visit your practice. Please be as accurate as possible.
Please note that only the Medical Practitioner in affiliation with your practice should sign below.
Please note that only the Health Care Practitioner in affiliation with your practice should sign below.