Become a member
Please fill out the form below. We will review your information as soon as possible.
Title
*
Salutation
*
Miss
Mister
Mix
First name
*
Name
*
Hospital / Practice
*
Street
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Postal code
*
Place
*
E-Mail
*
Diese E-Mail-Adresse ist ungültig.
Payment method
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1-year membership fee (CHF 30)
3-year membership fee (CHF 60)
Submit
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