MEDSAC Membership Application

Thank you for your interest in becoming a member of MEDSAC.

Please note that by submitting this membership/subscription form you are agreeing to abide by the MEDSAC Member Code of Conduct as specified on this website.


Doctor / Nurse Details:

Address
Please tick one option below.

MEDSAC Affiliate Applicants only.

Please provide in the message box above - Details of Referee (fellow clinician)

Name, Phone, Email, Position

And answer: "What is your clinicial interest in the area of Sexual Assault medicine?"