Please note that signing the application indicates acceptance of the following requirements: Members undertake to keep Medpro informed of their current contact information and any changes in their professional practice. In particular members must inform Medpro of any indication or knowledge of an adverse incident without delay. Failure to notify Medpro of an adverse incident without delay, or of a change to their contact information or to any scope of a member’s practice could result in the suspension of the benefits of membership and/or the termination of your membership. Members accept and understand that Medpro is not an insurance company. Medpro is a claims made protection company. The benefits of Medpro membership are granted at the discretion of Medpro and are subject to the Terms and Conditions of membership, as amended from time to time.

1. Failure to disclose full and accurate details about your practice and history may invalidate your membership which means you would not be entitled to any advice or assistance from Medpro.
2. If you have previously subscribed for any medical protection, professional indemnity or insurance you must disclose all information related to your practice.
3. As Medpro provides claims made protection, Medpro would not assist with any matter arising from an incident which does not emanate from the current period of Medpro membership.
4. If you are leaving another protection organization or insurance contract, please ensure you have notified your previous provider of any adverse incident of which you are aware of or which could become a claim.

I undertake to inform Medpro immediately, without any delay and within 72 hours of any knowledge or information that I may have with respect to any adverse incident, possible or potential claim, complaint, less than satisfied patient or less than satisfied patient relative or acquaintance, or a less than desirable treatment outcome. I understand that any delay in informing Medpro may result in the suspension of the benefits of membership and in particular may result in denial of service which means I would not be entitled to any advice or assistance from Medpro.

I wish to apply for membership with Medpro upon payment of the appropriate subscription amount and subject to the Terms and Conditions.

I understand that membership is not conferred automatically and is subject to approval. I consent to Medpro seeking information regarding past and current matters from other professional protection bodies, insurance companies or employers, and to the release of that information to Medpro. I consent to Medpro processing information about me.

I consent to Medpro using the email address provided for communication with me.

I confirm that the information I have provided is correct and that I have read and accept the Subscription Details above. I confirm that I understand how the claims based protection model functions and accept that any delay in informing Medpro of an adverse incident, claim, complaint, less than satisfied patient or less than satisfied patient relative or acquaintance, or a less than desirable treatment outcome, can result in the denial of the benefits of membership with Medpro and accept that I would not be entitled to any advice or assistance from Medpro.