Membership Application Print This Page
APPLICATION FOR MEMBERSHIP
Please download and print out the direct debit and send with your application to the address below.
Alternatively you may use our online payment option.

Criteria For Membership 
Membership is only available to doctors with a registerable qualification in the UK. All doctors with an interest in musculoskeletal medicine are welcome to join.

There are two levels of subscription, please circle yours:

1. "Ordinary" - for members with an interest in the subject, £75

2. "Higher Rate" - for members earning more than £10,000 pa from Musculoskeletal practice, £175 pa. Higher Rate members may opt to include their details on the Referrals page of the BIMM website.

Title...……......................................................................…......

Name and Initials .....………………………………........................

Surname........................…………………………....…......….......

Registerable Qualifications....................................…………......

G.M.C.no ...........................

Practice Name ........................................................................    

Practice Address................................................................          

................................................................................................ 
          
……….................................................................................…..

Post Code ......................................          

Telephone No.......................................................................         

Fax No.................................................................................         

Email...................................................................................  


Home Address ......................................................................  

.............................................................................................

.............................................................................................

Post Code.............................................................................

Telephone..............................................................................

Email....................................................................................

Type of Practice: NHS GP (single handed / partnership)

 ....………………………………............................…….............

Hospital (state grade)..........………..........................…….........

Private Practice (GP / Consulting)……………......….…..............

Other .....................................................………………..........


Please give a brief C.V. (indicating type of practice and time spent in each).






Please state your interest and/or experience in Musculoskeletal Medicine. (including how you initially got involved).






Please state how you first heard of BIMM.






Signed................................................. 

Dated...........................................

Please return to BIMM, PO Box 1116, Bushey WD23 9BY together with direct debit or cheque for  £65 / £150 (please circle). To pay by credit card (subject to 5% administration fee) telephone  0208 421 9910



British Institute of Musculoskeletal Medicine
BIMM