Basingstoke Team Parish

Membership

If you would like to become a member, please complete the form below. 

(Details protected under the data protection act 1998) 

Donate to PoTSBenefits of membership

  • Recieve a newsletter 3-4 times a year. 
  • Keep you informed about the latest research and journal publications.
  • keep healthcare professionals updated regarding educational events and research.
  • Maintain a database of people with PoTS and use this for research.

Membership is FREE to anyone who supports PoTS UK. Please consider making a donation using the purple button on the right. A small donation of £10 would help us pay for the running costs of PoTS UK.

Membership form

Please note fields marked with * are required and rest assured, we will never give your personal information to third parties without your consent

Your details
First Name*
Last Name*
Email Address*
Town or City*
County*
Country*
Your age range?
Under 20
20-29
30-39
40+
Prefer not to say

Choose your involvement with PoTS
Only choose "Medical Professional" if you are currently managing patients with PoTS
Are you a*
Patient
Carer/Friend
Medical Professional

Which consultant are you under for the management of your PoTS?
Your PoTS consultant's name
Your consultant's speciality?

Do you have any of the following diagnoses? Tick all that are relevant.
Your diagnoses
Postural Tachycardia Syndrome (PoTS)
Hyperadrenergic PoTS
Inappropriate Sinus Tachycardia (IST)
Chronic Fatigue Syndrome (CSF)
Joint Hypermobility Syndrome (JHMS)/ Ehlers-Danlos Syndrome (EDS)
Vasovagal Syncope/ Neurally Mediated Syncope (VVS/NMS)
Other
Complete security*
IMPORTANT: By signing up as a member you will automatically be subscribed to our PoTS UK newsletter. If you would prefer to not receive this you can simply unsubscribe at any point using the unsubscribe link at the bottom of the email.