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Account Details

Profile Details

Full Name (required)

Please fill in your full name adding your title is also optional.

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Please fill in your full name adding your title is also optional.

Birthday

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Medical Qualifications (required)

Here you can add as many or as little qualifications.

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Here you can add as many or as little qualifications.

Clinic Name (required)

The full name of the primary medical clinic your practice out of.

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The full name of the primary medical clinic your practice out of.

Location (required)

This address will be used on the members directory map, please make sure this address is valid for Google Map.

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This address will be used on the members directory map, please make sure this address is valid for Google Map.

County / Area (required)

Please select the county the clinic is in.

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Please select the county the clinic is in.

Clinic Telephone (required)

Please add international number format: +353 (area code) (number)

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Please add international number format: +353 (area code) (number)

Clinic Website

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Private - Medical Indemnity Registration Number

Private information only viewable by you and PCSA admins.

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Private information only viewable by you and PCSA admins.

Private - Medical Council Registration Number

Private information only viewable by you and PCSA admins.

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Private information only viewable by you and PCSA admins.

Private - CME Registration Body Number

Private information only viewable by you and PCSA admins.

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Private information only viewable by you and PCSA admins.

Private - Your work telephone number (required)

Add the full number, Area Code + Number.

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Add the full number, Area Code + Number.

Private - Your personal telephone number (required)

Add the full number, Area Code + Number.

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Add the full number, Area Code + Number.

PCSA Member Number

Add your PCSA membership number here if you have been allocated one.

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Add your PCSA membership number here if you have been allocated one.

Terms
(required)

PCSA network/website terms.

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PCSA network/website terms.