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// REGISTRATION
// PERSONAL INFORMATION
Day
Month
Year
// CONTACT DETAILS
// PROFESSIONAL CONTACT DETAILS
Rehabilitation Hospital
General Hospital
Community Rehabilitation facilities
Only private practice
Other Place of work if none of above
If necessary, please provide other information related to the registration process
// MEMBERSHIP DETAILS
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I declare that I am a PRM Doctor
Your certificate of proof, with your title of specialty must be sent within three (3) days from your registration to ESPRM Central Office by e-mail info@esprm.net. ESPRM has the right to decline your registration, and return your fee, if you do not meet the prerequisites.