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2021 Membership Renewal
Members can renew their membership for the year 2021 by selecting the membership type from the list below, confirming the statement and then clicking the Next button.
* I confirm that I am not aware of any claims or circumstances that might lead to any litigation or complaint in connection with my profession as a Chiropractor
Please check box to confirm statement
If applying for insurance, in addition to membership, please complete the sections below:
Have you under current or previous trading titles been convicted of any criminal offence, other than motoring, or are there any prosecutions pending?
No
Yes
Have you ever had any complaints made against you which have or are likely to involve the GCC?
No
Yes
Have any insurers ever cancelled, declared void, declined or refused to renew any insurance, or accepted the risk at special terms or repudiated any claim?
No
Yes
Have you had any claims, or incidents, which could give rise to a claim under any policy involving negligence, error or omission, or are you aware of any circumstances which may result in a claim or suit being made against you?
No
Yes
If you have answered Yes to any of the above questions please provide full details. Please note that cover will only commence when the insurers have confirmed their acceptance.
It is your duty to disclose all material facts. A material fact is one that would influence our decision as to whether or not to accept your proposal for insurance, and if we were to accept your proposal, the terms on which we would insure you and the premium we would want to charge you. If you are in any doubt as to whether a fact is material you should disclose it.
Declaration
I/We declare that the statements and particulars contained in the proposal are true and that I/we have not misstated or failed to disclose any material facts. I/We agree that this proposal together with any other information supplied by me/us shall form the basis of any contract of insurance consequently affected between me/us and the insurer. I/We undertake to provide details of any material alteration to these facts occurring before the insurance contract is effected or during the period of insurance.
Agree
Disagree
Full Membership (Inc. Insurance)
£1172
Associate Membership (Inc. Insurance)
£1172
Full Membership (Exc.Insurance)
£320
Associate Membership (Exc. Insurance)
£320
Overseas Membership
£125
Retired Member
£125
Sponsor a Student Member
£30
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Saint Helena
Saint Kitts And Nevis
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Us Minor Outlying Islands
Uzbekistan
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Viet Nam
Virgin Islands, British
Virgin Islands, U.s.
Wallis And Futuna
Western Sahara
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Zambia
Zimbabwe
* E-Mail Address
* Confirm E-Mail Address
* Telephone number
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