Membership Renewal

Annual Membership is £45.00 per year (subject to change). You will be notified of your acceptance & membership will start upon receipt of the fee.

Please complete the form below to renew your subscription:
 
Name:
Business/surgery:
Email:
 
Are there any changes: YES NO
 
If yes, please complete the box below telling us of any changes.
 
Any new certificates, please send PDF/photo copies to: members@acupuncture-acutherapy.co.uk
 
Declarations
 
I confirm that there have been no disciplinary findings against me.
True False
 
I confirm there have been no successful claims against my Professional Indemnity Insurance.
True False
 
I confirm that there are no outstanding professional complaints against me.
True False
 
I confirm that there have been no criminal convictions or cautions against me (not inc. motor offenses punishable only by a fine).
True False
 
I confirm that there are no health issues affecting my ability to practise.
True False
 
I confirm that I have Professional Indemnity Insurance to practise in my Country.
True False
 
I confirm that I will respond to any request from AcuC for evidence of my Professional Indemnity Insurance, CPD Activities and Qualifications.
True False
 
If False to any of the above declarations, please explain below:
 
Insurance
Do you require information about AcuC's approved Professional Indemnity Insurance?
Yes No
 
Insurance Company:
Insurance Policy No:
 
 
Code of Professional Conduct and Safe Practice
I have read and will comply with AcuC's Code of Professional Conduct & Safe Practice
True False
 
Code of Professional Conduct and Safe Practice
 
Data Protection Act 2018 (GDPR)
Practice address(es) - the only publicly available information on the Register will be your name, town/city, postcode, telephone number of your practice, email and/or web address, disciplines for which you are registered and date on which your registration expires.