Apply to Join Drainology™

Why participate as a member of Drainology™? Membership lets you find an area that really matters to you – that’s impactful to what you do and what your interests are – and contribute in a much more meaningful way. It allows you to network and exchange thoughts, questions, and ideas. Only healthcare professionals are eligible to join and make contributions, and every member is responsible for his or her contributions within the member area.

The members-only area of our website is still being finalized. If you are a healthcare professional interested in becoming a member of the Drainology™ network, please fill out the required fields below. We are pleased to receive your application here and will inform you as soon as our membership area is active.

Fieldset

Title
First Name *
Last Name *
Email Address *
Clinic *
Hospital *
Specialty Area *
City *
Country *
Why would you like to join Drainology™?
Where did you hear about us?
Username *
Password *
Membership Level *
Drainology Member
* Indicates a required field
I agree that if my application is accepted I will be listed as a member and the following data will be published within the Member Area: Title, First Name, Last Name, Clinic, Hospital, Specialty Area, City, Country. (Optional)
I agree to receive news & updates about the Drainology™ Webpage. (Optional)
*
I have read and agree to Drainology™'s Data Protection Terms *

Verification

Please enter any two digits with no spaces (Example: 12)*
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