IHPBA Faculty Directory

  • IHPBA Faculty Directory

  • 1. Are you a current IHPBA member*

  • The IHPBA Faculty Directory is available to IHPBA members, for more information and to join,  please visit https://www.ihpba.org/14_FeesApplications.html 

  • 2. Are you in independent practice? Completed all training and in practice without supervision or retired.

  • This registry is for individuals who are currently in practice or retired and excludes, medical students, residents, trainees and fellows.  

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  • 11. Date of Birth*
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  • 13. Are you a Member of a National Chapter*
  • 14. Please confirm your clinical focused expertise (select all that apply)*

  • Please confirm your research focused expertise

  • 15. Type of Research (select all that apply)*
  • 16. Please confirm whether you are able to give a presentation, chair a session or both?*
  • 17. Are you comfortable to present in English*
  • 18. Please select your Academic Rank?*

  • Consent

  • I consent to the IHPBA Management Office retaining my information for the IHPBA Faculty Directory and contacting me by email*
  • I consent to the details collected on this form being passed on to the IHPBA Scientific Programme Committee*
  • I consent to my details (name, email, insitution, country, expertise and experience ) being published in the faculty directory on the IHPBA website*

  • Thank you!

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