MEMBERSHIP RENEWAL APPLICATION

To renew your membership, please:

1. Fill in the form below (alternatively, click here to download a postal application form)

2. After submitting the form, please make your payment. Payment can be made either for 1 year or you can set up an annual auto renewal.

Membership Renewal Application Form


Contact Details


Main Clinic Address and Contact Details


Clinic 2 Address and Contact Details (if you have more than one clinic)


Clinic 3 Address and Contact Details (if you have more than two clinics)


Correspondence details if different from clinic details


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