Renewal Form for Full URHP Membership

The annual renewal deadline for existing members is 31st March.

To renew your membership of the URHP, please complete the electronic form below and follow the steps through to completion where you will have the option of paying via PayPal, or Bank Transfer.

Your completed form is AUTOMATICALLY sent to the URHP Registrar's email account so there is no need to print off and send unless you wish to.

If this is the case, please return by post to URHP Registrar, 34 Hogarth Hill, London NW11 6BA.

Please scan and email your CPD forms and insurance certificate to complete your application to: urhpregistrar@yahoo.com

Personal Details

Title:

Name:

Home Address:

Telephone Number:

Internal Email Address *:

Referral Email Address **:

Include referral email address on URHP website and directory? **

Details and Qualifications for our website and referral list

Have you obtained any qualifications during the last year? If yes, give details of course/college, qualification and date obtained:

Have any of your practice details changed? if yes, give details:

Have any of your details on the website changed? If yes, give details:

I am based in

Payment Method:

I wish to pay in:

* For safety alerts & URHP/EHTPA internal communications; too much volume to send by post.
** For referrals. Email address is not visible on URHP website Directory. An online contact form is provided instead.