Membership Sign-up form

*** IMPORTANT ***

Do you work in Paediatrics? Please join our Paediatrics neurotoxin network.

This allows us to provide both Paediatrics and Adult Neurotoxin Networks. Thank You.

Please fill out the form below to apply or to renew your annual membership.

Your Profile Details

Hospital

I am a Botulinum toxin injector, who specialises in treating conditions, such as dystonia, spasticity, pain,or dysautonomia (drooling, hyperhidrosis).