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Stock and equipment insurance application form

For FHT Member and FHT Associate levels only, based in the UK

If your qualifications were undertaken outside of the UK please only proceed if you can provide us with your qualification certificate(s) and transcript(s) officially translated into English.

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Personal details

Title (Mr/Mrs/Miss/Ms/other - please specify) *

First name *

Surname *

Date of birth (dd/mm/yyyy) *

Email *

Confirm your email *

Mobile tel *

If you were previously a member of the FHT and
have your membership number to hand, please insert it here:

Home address

House name or no. *

Street *

Town/city *

County *

Postcode *

Home tel

Website

Business details

Business name (leave blank if not applicable)

Business address (if different)

House name or no.

Street

Town/city

County

Postcode

Business tel

Please select the address you would like correspondence sent to *

Home

Business

As your professional association we will endeavour to send information relevant to your membership status and professional practice, including regulatory and legislative updates using the contact details supplied above.

Please indicate if any of the following apply:

I work in a clinical practice (such as a hospital, hospice, GP surgery)

I employ other therapists

I teach therapies to other therapists

For data protection purposes we will set up a security question and password in order to identify you whenever you call and if you would like to renew your membership online.

Security question: *

Answer to your security question: *

Security password (6-8 characters including one number): *