Join Us - AFPA

Membership of the AFPA is open to acupuncturists and practitioners of Chinese Medicine as well as graduates of courses in Acupuncture and Chinese Medicine that meet AFPA guidelines.

To apply please fill out the form below.

APPLICATION FOR MEMBERSHIP 2011 - 2012

First name
Surname
Date of Birth
Nationality
Gender
Personal Tel. No.
Email
College Attended
Practice status
Currently practicing
Starting practice
Student
Returning to practice
Length of break in service
Home address
Practice Details
Telephone
Mobile
Website URL
Email
Specialised training
Interested in treating
Qualifications
Practice Address 1
Practice Address 2
Previous Association Membership
Association
Date joined
Date left
Professional Insurance
Insurer
Cover dates

Undertakings:
Please answer the following:

Have you ever been denied Professional Membership of a TCM Association
Have you ever been denied Professional Insurance
Have you ever had an Insurance Claim against you
Have you ever been investigated by the Police in any country
Are there current of issues of physical or emotional health which could impact on your practice
Do you wish to be included on our block insurance?*
*(AFPA Block Insurance rate for 2010/11 - €160 (€4 million cover) - €190 (€6 million cover). Instructions for joining insurance scheme provided on membership acceptance.) I confirm all of the above statements to be true and there is no reason known to me why I would be considered unfit to practice a primary healthcare therapy. I agree to comply with the codes of ethics and practice of the AFPA.
Date: