Register (FMD)

IMPORTANT:

  • The below form is for registration of NEW members. Existing / previous members are requested to log in and follow these instructions.
  • Please DO NOT create a new profile if you have an existing profile with the HSA. To find out if you have an existing profile or any related queries please contact the HSA.
  • Please ensure that CAPS LOCK is switched off and complete as many fields as possible.
  • Memberships will only be processed and allocated a membership number upon the verification of successful payment.
Select a password you will remember and store securely for future use.
Primary practice details if available.
10 digits, no spaces
10 digits, no spaces
10 digits, no spaces
10 digits, no spaces
I wish to undertake the stated membership type for the stipulated year.
I confirm that I am duly registered with the Allied Health Professions Council of South Africa (AHPCSA) as required. I agree to pay the subscription and to abide by the Constitution of the Association, and the rules of the region to which I may belong at any time.
I hereby provide permission for the HSA to send me communications via email or post regarding activities of the association, important events and seminars as well as billing information.

NOTE:
1. After submitting your information, an email will be sent to you and you will be requested to log in to the HSA site using your email/username and pre-selected password.
2. You may then select your appropriate level of membership and preferred means of payment.
3. Please note that membership confirmation is fastest using the secure PayFast payment gateway.
4. No HSA membership will be regarded as valid pending the successful completion of the required payment.
5. The HSA reserves the right to terminate any membership which is not permitted in line with its constitution.

**By submission of this form you have confirmed being notified of the the HSA's declaration of collection of personal information as per s18 of the Protection of Information Act, 2013 (Act 4 of 2013).

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