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Welcome to your Membership Portal

Please fill out the form below to tell us about yourself. **PLEASE NOTE: WE ARE ONLY ACCEPTING CANADIAN MEMBERS**

APPLICANT INFORMATION - FULL MEMBER

Name *

First Name

Last Name

STREET ADDRESS: *

CITY: *

PROVINCE: *

Alberta

British Columbia

Manitoba

New Brunswick

Newfoundland and Labrador

Nova Scotia

Ontario

Prince Edward Island

Quebec

Saskatchewan

POSTAL CODE *

PRIMARY PHONE: (PLEASE PROVIDE A WHATSAPP NUMBER) *

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EMAIL: *

APPLICANT'S QUALIFICATION FROM PAKISTAN

NAME OF INSTITUTE: *

DEGREE AWARDED: *

Allied Health

BScN

MBBS

Med Student

Other

If other, please specify:

YEAR OF COMPLETION (Med student: expected year of completion) *

APPLICANT'S QUALIFICATION OUTSIDE PAKISTAN (If applicable)

NAME OF INSTITUTE: *

DEGREE AWARDED: *

Allied Health

BScN

MBBS

Med Student

Other

If other, please specify:

YEAR OF COMPLETION: (Med student: expected year of completion)

EMPLOYMENT INFORMATION

CURRENT EMPLOYER: *

POSITION: *

AREA OF PRACTICE: *

Cardiologist

Dematologist

ENT

Family Physician

Internist

Neurologist

Ophthalmologist

Orthopedist

Pathologist

Pediatrician

Psychiatrist

Radiologist

Surgeon

Other

If other, please specify:

WORK ADDRESS:

EMERGENCY CONTACT

NAME OF RELATIVE OR FRIEND: *

EMERGENCY CONTACT PHONE: *

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I consent to my name and contact information (as available through my professional college website/directory) to be included in the APPIC physician directory. I understand that this APPIC physician directory will only be available to APPIC members for professional and social networking and not for commercial purposes. *

I understand

I decline

Thank you!

Professional Guidance Hub

Access personalized guidance and advice from experienced physicians.

Lifelong Learning Center

Stay ahead with our diverse collection of workshops, seminars, and educational resources.

Community Integration Corner

Engage with our community initiatives promoting cultural awareness and social integration.

Need assistance?

For any inquiries, assistance or feedback, please reach out to our Member Services team at appiccanada@gmail.com. We are here to support you on your professional journey.

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Association of Pakistani Physicians in Canada; bringing Canadian-Pakistani physicians under one umbrella to support their professional and personal well-being.

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