Become a member

Supporter membership form

Use this form...

This form is for all members who are not reporting a new case of TM, ADEM or NMO: health professionals, researchers, journalists, friends and family and all other supporters, where the person with TM is already registered with the TM Society.

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...from the menu at the top of the page, or return to the Membership front page to review the choices.

Membership

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Contact information

Member name *

First

Last

Email *

Please take extra care to check that your email address is entered correctly.

Telephone *

We will only telephone you if your email address stops working.

Postcode *

Address Line 1 *

Address Line 2 *

Town or City *

About you, as a supporter

Type of supporter *

Neurologist Other consultant GP Physiotherapist Nurse Social worker Other health professional Researcher Journalist Other charity Spouse Other relative Friend Carer Other (please specify below)

Other supporter type *

Please describe your involvement with TM, ADEM or NMO if you answered Other to the question above.

Getting involved

We are all volunteers in TM Society.
Do you want to help? *

Yes No

Thank you for becoming a member...

You will receive a Welcome email with more information about TM and the UK TM Society in the next couple of weeks.

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