Application for FSRH Associate Membership

Thank you for your interest in becoming an Associate member of FSRH. 

Associate membership can be awarded to medical practitioners and nurses who do not hold the Diploma, Membership Exam or are a current Fellow but may have been awarded a Letter of Competence. 

If you would like a copy of your responses (which can be useful, should you apply for other things in the future), please add your email address in the relevant field at the bottom of this form. 

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here.

* Indicates a required field.

Personal Details

Please can you give us some personal details to enable us to easily contact you about next steps to becoming an Associate member.

Which Letters of Competence have you submitted applications for?*

Please click the box to indicate you are a human rather than an automated system completing this form.

Last step

Thank you for submitting this form, we aim to contact you within 5 working days to confirm next steps.