Add, Change, or Update the Professional Bodies
Insurance information

    All fields are mandatory unless otherwise indicated.

    Professional Body Name (as found on the Professional Bodies Directory):

    Date of change (DD/MM/YYYY):

    Reason for change:

    Country

    MAIN CONTACT DETAILS:
    If the main contact changes or their details change, please email communication@ircmcic.org with updated details, with your Professional Body name in the Subject line.

    Name:
    prefix
    first name
    middle name/initial (optional)
    last name
    suffix (please put each suffix on a new line)

    Position held in the Professional Body:

    Email:
    Your email address will only be used to contact you in relation to your entry on the Directory. If your email address changes, please email communication@ircmcic.org with updated details, with your Professional Body name in the Subject line.

    Telephone number:
    Your telephone number will only be used to contact you in relation to your entry on the Directory.

    INSURANCE:
    The insurance details entered here will need to be updated annually or more frequently.
    Insurance Organisation:
    Insurance Type:
    Certificate Number:
    Date first issued (DD/MM/YYYY):
    Date expires:

    ADDITIONAL INFORMATION:
    Please enter any Additional Information relevant to your Directory entry (optional)

    .

    .

    Currently, all information provided by and correspondence with the IRCM CIC is in English.