Register your support as a member

Member Registration

Please use this form to register as a member of the Eye and Face Network. Once registered, there are a few other fields (such as profession and subspecialty) you will be able to complete at the next stage.

First
Last
Enter Email, this will be used as your username to log into this website.
Confirm Email
Choose your password to allow you to log into this website.
Confirm Password
(main place of work, or affiliation)
Of which recognized international or national medical society are you already a member (eg ASOPRS, ESCRS)? Please state one. This data will be used to validate your application to the Network.
(e.g., MD, FRCOphth, etc)
My chief areas of ophthalmic expertise include (tick one or more):
Join virtual group
Would you be prepared to join a virtual group in your region/time zone to provide advice (related to your specialty) to colleagues dealing with patients injured in conflicts and catastrophes? You can change this decision at anytime by ticking/unticking this box
Please include country code, eg +44
Opt-in permissions
(optional, you change this at any time)
I am willing to be contacted directly by another Member on the Network to discuss clinical case(s) as required

After submitting this form your details will be validated before activating your account.