Apply for fellow membership

If you are a medical fellow in Nova Scotia, you are eligible for membership with Doctors Nova Scotia. Your membership dues will be waived if you supply a signed letter from your supervisor specifying your fellowship end date.

Please complete the application form and a membership officer will contact you.

This application form cannot be saved. Refreshing your browser or moving away from the application form will result in your information being lost.

Name

Date of Birth

With which gender do you most identify?

Please specify

Which of the following best describes your preferred pronoun?

she, her, hers

he, him, his

they, them, theirs

I prefer not to answer

Home address

Address

Address 2

City/Town

Province

Postal Code

Country

Office phone

Cell phone

Primary email address

Professional Information

Medical school

Year of graduation

Specialty as approved by the College of Physicians & Surgeons of Nova Scotia

Fellowship start date

Fellowship end date

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