Please complete all the following form and click “Send”. After sending it, pay the membership fee using the payment methods that will appear after sending the application. AEPROMO will contact you once the Board has decided on his request

Name (required)

Surname (required)

Direction (required)

City (required)

Province (state, department) (required)

Community (mandatory only for persons in Spain)

Zip code (required)

Country (required)

Phone (required)

Email (required)

Profession (required)

Speciality (If you have it) (required)

Twitter (if available)

Web (if available)

Birth Date (required)

NID (National Identity Document or similar) (required)

Your number of Medical College of Physicians or Professional Identity Card (required)

Name of the Medical College of Physicians to which you belong or entity that issued your professional card (required)

Only if you have a bank account in any country of the European Union

Order payment by direct debit:

Company bank account

I accept Privacy Police de AEPROMO (obligatorio)

I accept the sending of commercial communications

To avoid spam, please answer this security question

Persons not resident in Spain must submit the following scanned documents by email to ” info@aepromo.org

  • NID (National Identity Document or similar)
  • Medical College of Physicians or Professional Identity Card

This content is also available in: Spanish