Name:*
First Name
Last Name*
First Name Required
Last Name Required
Billing Address
I am 21 years and older*
I am a UAE resident for 3 years or more*
Please acknowledge that you are not in any diplomatic position*
Date of Birth:*
Date of Birth is Required
Gender
Gender:*
Gender is Required
Male
Female
Prefer not to say
Nationality:*
Nationality is Required
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde (Cabo Verde)
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
North Korea
North Macedonia
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
São Tomé and Príncipe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Emirate:*
Emirate is Required
Abu Dhabi
Dubai
Sharjah
Ajman
Umm Al Quwain
Ras Al Khaimah
Fujairah
Emirates ID Number:*
Emirates ID Number is Required
Emirates ID Upload:
Emirates ID Upload is not valid
Title:*
Title is Required
Dr
Prof
Mr
Mrs
Miss
Current Position:*
Current Position is Required
Doctor
Technician
Resident
Nurse
Pharmacist
Student
Others (Healthcare Professional)
Current Position (If "Other", please specify):
Current Position (If "Other", please specify) is not valid
Level of Education:*
Level of Education is Required
MBBS (MD)
Bachelor’s
Master’s
PhD
Other
Level of Education (If "Other", please specify):
Level of Education (If "Other", please specify) is not valid
Licensed Speciality:*
Licensed Speciality is Required
Medical License Number (N/A if not available):
Medical License Number (N/A if not available) is not valid
Medical License Issued By:*
Medical License Issued By is Required
DHA
DOH
MOH
DHCC
N/A
Place of Work / Study:*
Place of Work / Study is Required
Type of Work:*
Type of Work is Required
Government
Private
Academic
N/A
Please indicate if any of the following apply to you:
Please indicate if any of the following apply to you::
Please indicate if any of the following apply to you: is not valid
I am a senior (aged 60 or above)
I am a person of determination
Mobile Number:*
Mobile Number is Required
Work Number:*
Work Number is Required
Photo:
Photo is not valid
Professional Educational Certificate:
Professional Educational Certificate is not valid
Business Email Address:
Business Email Address is not valid
I confirm that all information provided is accurate and complete, and I accept full responsibility for any misinformation submitted.*
Username:*
Invalid Username
Email:*
Invalid Email
Password:*
Invalid Password
Password Confirmation:*
Password Confirmation Doesn't Match
No val
Please fix the errors above
Pay
Free Membership *valid until the end of the joining year
EORA Member – Payment
Free Membership *valid until the end of the joining year
AED0.00
Scroll to Top