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Membership Form
Fill out this form for the request.
[/av_textblock]
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Location
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Hospital de Poniente
Carretera de Almerimar, 31, 04700 El Ejido, Almería
Hospital Virgen de las Nieves
Av. de las Fuerzas Armadas, 2, 18014 Granada
Hospital Virgen de la Victoria
Campus de Teatinos, S/N, 29010 Málaga
Complejo Hospitalario de Jaén
Av. del Ejército Español, 10, 23007 Jaén
Hospital universitario Reina Sofía
Av. Menéndez Pidal, s/n, 14004 Córdoba
Hospital Nuestra Señora de Valme
Av. de Bellavista, s/n, 41014 Sevilla
Hospital Puerta del Mar
Av. Ana de Viya, 21, 11009 Cádiz
Hospital Universitario de Ceuta
Urbanización Loma Colmenar, s/n, 51003 Ceuta
Hospital comarcal de Melilla
Calle Remonta, 2, 52005 Melilla
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Fill out this form for the request
[/av_heading]
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[av_contact_field label=’Bank account holder’ type=’text’ options=» check=’is_empty’ width=» multi_select=» av_contact_preselect=»][/av_contact_field]
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[av_contact_field label=’IBAN code’ type=’text’ options=» check=’is_empty’ width=» multi_select=» av_contact_preselect=»][/av_contact_field]
[av_contact_field label=’I have read and accept the conditions for the registration application. I authorize to charge the annual membership fee of the Asociación Andaluza del Dolor y Asistencia Continuada’ type=’checkbox’ options=» check=’is_empty’ width=» multi_select=» av_contact_preselect=»][/av_contact_field]
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Your request will be presented at the next meeting of the Board of Directors and you will be informed of the decision.
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