Associate Membership (UK)

Allied healthcare professional who is fully qualified, or in training, practising in a field relating to spinal surgery/injury, neurosurgery, neuroanaesthesia or neuro critical care in the UK or Ireland.

Full Name(Required)

Title(Required)

Speciality(Required)

Registration Number(Required)

Email(Required)

Enter Email Confirm Email

Main Hospital of Work(Required)

Contact Telephone Number(Required)

Home Address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Head of Department Name(Required)

Head of Department Email(Required)