Membership application form

You can complete the online membership application form by clicking here.

Questions marked with an * are required information.

Alternatively, you can phone our membership office on 01278 432167, send us an email at members@somersetft.nhs.uk or print and complete the application form below and send to:

The Membership Office
Somerset NHS Foundation Trust
Mallard Court
Express Park
Bristol Road
Bridgwater
TA6 4RN

The information you provide on your membership application form will remain confidential and will be managed in accordance with the Data Protection Act (1998).

What happens next? 

When you have completed the online form or sent us your completed form by post, we will send you an acknowledgement.

Email correspondence is always encouraged, as this is both less expensive for you and us, and also helps us achieve our environmental objectives.

 

If you would prefer to print out the application form and post it back to us, you can access the form below:

Application Form