Jump to navigation
Search form
Search
Header Right
0203 910 4531
Join us
Member Menu
Member Login
Menu
Main menu
Membership
About
Meet the Team
The Council / Board
Coronavirus
Work, worklessness and health
Research and Academic Forum
MSK at Work Network
Special Interest Groups
Blog Posts
Donate to SOM
Quality and Certifications
The QAAS Appraisal Scheme
Annual Occupational Health Awards 2020
Contact
SOM global consultancy
Register of CESR candidates
Mental Health Consensus Statement
Regional networks
Central Southern
East Midlands
International
London
North East
Northern Ireland
North West
Scotland
South Wales and West of England
West Midlands
Yorkshire
OH jobs
Current Vacancies
Advertise OH jobs
Careers in OH
Find an OH service
About the Professional Directory
Find an OH Professional
Find an OH Provider Company
Corporate Supporter
Events
Advertise an event
SOM Webinars
Work and Health
Back to top
Member by DD
Member by DD
If you have a discount code, enter it here
Membership
*
Member by DD - Pro-rata: Mar to Dec
-
£ 187.50
Membership will renew automatically.
Total Amount
Please enter a Username to create an account. If you already have an account
please login
before completing this form.
Username
*
Check Availability
Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.
Password
Confirm Password
Provide a password for the new account in both fields.
Name, Address and Email
Individual Prefix
*
Mrs
Ms
Mr
Miss
Dr
Rt. Honourable
Prof
Sir
Dame
First Name
*
Last Name
*
Street Address (Primary)
*
Supplemental Address 1
Supplemental Address 2
City
*
Post Code
*
County
*
- select -
Aberdeen City
Aberdeenshire
Angus
Argyll and Bute
Bedfordshire
Berkshire
Bristol, City of
Buckinghamshire
Cambridgeshire
Cheshire
Clackmannanshire
Clwyd
Co Antrim
Co Armagh
Co Down
Co Fermanagh
Co Londonderry
Co Tyrone
Cornwall
County Durham
Cumbria
Derbyshire
Devon
Dorset
Dumfries and Galloway
Dundee City
Dyfed
East Ayrshire
East Dunbartonshire
East Lothian
East Renfrewshire
East Riding of Yorkshire
East Sussex
Edinburgh, City of
Essex
Falkirk
Fife
Glasgow City
Gloucestershire
Greater Manchester
Gwent
Gwynedd
Hampshire
Herefordshire
Hertfordshire
Highland
Inverclyde
Isle of Wight
Kent
Lancashire
Leicestershire
Lincolnshire
London
Merseyside
Mid Glamorgan
Midlothian
Moray
Na h-Eileanan Siar
Norfolk
North Ayrshire
North Lanarkshire
North Yorkshire
Northamptonshire
Northumberland
Nottinghamshire
Oldham
Omagh
Orkney Islands
Oxfordshire
Perth and Kinross
Powys
Renfrewshire
Rutland
Scottish Borders
Shetland Islands
Shropshire
Somerset
South Ayrshire
South Glamorgan
South Gloucestershire
South Lanarkshire
South Yorkshire
Staffordshire
Stirling
Suffolk
Surrey
Tyne and Wear
Warwickshire
West Dunbartonshire
West Glamorgan
West Lothian
West Midlands
West Sussex
West Yorkshire
Wiltshire
Worcestershire
Country
*
- select -
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Carribean Netherlands - Bonaire, Sint Eustatius and Saba (Netherlands Special Municipalities)
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo, Republic Of The
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Sint Maarten (Constituent Country of the Netherlands)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Southern Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Email (Primary)
*
Phone
*
You should not continue with this form if any of the following apply:
You are not the account holder.
If it is a business account and more than one person is required to authorise debits on this account.
Direct Debit Information
Please confirm that you are the account holder and only person required to authorise Direct Debits from this account
*
Preferred Collection Day
*
1st
15th
Confirm By
*
Email
Post
Account Holder
*
Bank Account Number
*
Sort Code
*
My billing address is the same as above
Billing Name and Address
Billing First Name
*
Billing Middle Name
Billing Last Name
*
Street Address
*
City
*
Country
*
- select -
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Carribean Netherlands - Bonaire, Sint Eustatius and Saba (Netherlands Special Municipalities)
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo, Republic Of The
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Sint Maarten (Constituent Country of the Netherlands)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Southern Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
County
- none -
Aberdeen City
Aberdeenshire
Angus
Argyll and Bute
Bedfordshire
Berkshire
Bristol, City of
Buckinghamshire
Cambridgeshire
Cheshire
Clackmannanshire
Clwyd
Co Antrim
Co Armagh
Co Down
Co Fermanagh
Co Londonderry
Co Tyrone
Cornwall
County Durham
Cumbria
Derbyshire
Devon
Dorset
Dumfries and Galloway
Dundee City
Dyfed
East Ayrshire
East Dunbartonshire
East Lothian
East Renfrewshire
East Riding of Yorkshire
East Sussex
Edinburgh, City of
Essex
Falkirk
Fife
Glasgow City
Gloucestershire
Greater Manchester
Gwent
Gwynedd
Hampshire
Herefordshire
Hertfordshire
Highland
Inverclyde
Isle of Wight
Kent
Lancashire
Leicestershire
Lincolnshire
London
Merseyside
Mid Glamorgan
Midlothian
Moray
Na h-Eileanan Siar
Norfolk
North Ayrshire
North Lanarkshire
North Yorkshire
Northamptonshire
Northumberland
Nottinghamshire
Oldham
Omagh
Orkney Islands
Oxfordshire
Perth and Kinross
Powys
Renfrewshire
Rutland
Scottish Borders
Shetland Islands
Shropshire
Somerset
South Ayrshire
South Glamorgan
South Gloucestershire
South Lanarkshire
South Yorkshire
Staffordshire
Stirling
Suffolk
Surrey
Tyne and Wear
Warwickshire
West Dunbartonshire
West Glamorgan
West Lothian
West Midlands
West Sussex
West Yorkshire
Wiltshire
Worcestershire
Postal Code
*
Membership information
Profession
*
Chief Medical Officer
Senior Medical Officer
Medical Officer
Consultant OCC Physician
Independent OHP
Senior Medical Research Fellow
Consultant Psychiatrist
Associate Specialist
NHS Specialty Doctor
Armed Services Consultant
Lead Physician
Medical Advisor
NHS Associate Specialist
Senior Clinical Fellow
Senior Occupational Health Nurse Advisor
Occupational Health Nurse
OH Nurse/Advisor
Specialist Practitioner OH Nurse
Occupational Health Advisor
Physiotherapist
Ergonomist
Psychologist
Occupational Therapist
Independent Consultant
Toxicologist
Senior House Officer
Epidemiologist
Research Scientist
General Practitioner (GP)
Medical Practitioner
Primary Care Physician
Independent Psychiatrist
NHS Occupational Physician
Specialty Registrar
Occupational Health Inspector
Specialist Trainee
Health and Safety Advisor
Doctor in Disability Assessment
Aviation Medical Examiner
Army General Practitioner
Trainee
Interventional Radiologist
GP Trainee
Disability Assessor
Occupational Hygienist
NHS Consultant
Doctor residing in EU
Overseas (outside EU) doctor
Occupational Health Technician
Other profession (e.g. non-clinical)
Dentist
My Affiliations are (OH-related bodies):
I am registered with:
*
ACPOHE
GMC
HPC
IEHF
NMC
Other
I am not registered
If 'Other' is selected, please state here:
Other
SOM Regional Group (please select which group you'd like to join)
*
- select -
Central Southern
East Midlands
London
North East
North West
Northern Ireland
International
Scotland
South Wales and West of England
West Midlands
Yorkshire
How did you hear about us?
*
If you were recommended by another SOM member please enter their full name here:
I declare that the above information is true. I am in good standing with my professional regulators or relevant governing body and I am not subject to supervision and/or restrictions on my practice, nor the subject of any proceedings pending against me. I understand that being a member of the SOM does not confer entitlement to any post-nominal qualifications or use of the SOM logo. I understand that membership may be withdrawn if I act contrary to the charitable objectives of the SOM.
Declaration:
*
Confirm
I agree that my personal data will be used so that the SOM can contact me regarding member benefits such as e news, renewals, regional and national events and job alerts and give my permission for my information to be passed to Oxford University Press so that I can receive the Occupational Medicine Journal, and to James Hallam so that I can be contacted about Nurse Indemnity Cover, if applicable. You are free to update preferences within the member area.
Communications Opt-In Declaration
*
Confirm
Agreement
Your account data will be used to charge your bank account via direct debit. While submitting this form you agree to the charging of your bank account via direct debit.