IPPN Membership Application Form

The International Patient Power Network welcomes patient organisations, individual advocates, caregivers, community leaders, and other stakeholders who are committed to strengthening the patient voice.

Membership is free of charge.

Please complete this form so we can better understand your work, interests, needs, and how IPPN can support you or your organisation. After recieveing your application, we will invite you to a short video call, as part of the application process. After the video call, we will get back to you with our decision about the membership within 30 days.

Main target groups*
In which areas could you contribute?*
        I confirm that the information provided in this form is accurate.*
        I agree that IPPN may contact me regarding membership, activities, events, and support opportunities.*
        I agree that IPPN may store and process my data for membership-related purposes.*
        I understand that I can request the correction or deletion of my data at any time.*
        I agree that my organisation/name may be listed as an IPPN member.*
        I agree to receive newsletters and updates from IPPN. (optional)
        I agree to be contacted about collaboration opportunities. (optional)
        I agree that my organisation/name may be listed as an IPPN member. (optional)