Professional membership form

Content

Professional membership form

Please read our Guide to KPIN Membership before completing this form.

The confidentiality of your personal information is of paramount concern to us. KPIN will treat your details in confidence and in accordance with current data protection laws. For more information on how we use and store your data, see our Privacy Policy

Please note this form is intended for professionals only. If you are a patient/carer, please use the patient/carer membership form.

* indicates a compulsory field

Contact details

1. Name*

2. Email *

Please tick here to confirm that we can contact you by email: * You can unsubscribe at any time by emailing info@KPIN.org.uk

About you

Any data you enter below will only be used to provide you with appropriate information resources and opportunities, as detailed in our Guide to KPIN Membership

3. I am a ... * (Select all that apply)
AcademicCounsellorDieticianMedical doctorNursePhysiotherapistPsychologistResearcherOther (please describe)

4. Organisation *

What would you like us to email you about?

5. I would like to receive information on: * (Select all that apply. You can contact us to change this at any time)
KPIN training/eventsWebsite updates

6. Would you like to receive the monthly KPIN newsletter? *

7. I have the following skills and would be happy to help within the network (Select all that apply)
Developing and encouraging PPI/EMarketing and communicationSocial mediaTraining and educationOther (please describe)

8.

PLEASE NOTE: Soon after registering to join KPIN, you will receive a Welcome email. If this does not automatically arrive, please be sure to check your Spam filter.

KPIN is funded by Kidney Care UK

Join us on Social Media

KPIN is on the most popular social networks.

Skip to content