UHO membership form

Please fill this form for UHO membership and to endorse UHO vision.

I wish to endorse UHO vision, and register as UHO member I wish to endorse UHO vision, but not register as UHO member

Note related to UHO membership:

At this time, we are open only for non-voting (annual) membership for the public.
Voting membership will be open by June 2024, and will be based on active participation by members in UHO activities.
Please see our rules and regulations, specifically section-4, for more details.

Before proceeding with this form:

Please make payment of Rs. 200 via UPI, and note the transaction details
UPI scan code:

Endorsement:
“I support the vision and charter of UHO, and endorse the method of open discussion and debate to promote transparency, empowerment, and accountability on matters related to public health”. Please read here before filling the form.

Name: *
Country: *
Email address *
(will NOT be displayed/shared):

Signing as: *
Concerned citizen
Medical practitioner
Professional/scientist/academician

Details required for UHO membership:

Registration fee (Rs. 200) payment date: Payment transaction ID
Mobile number (will NOT be displayed/shared):
Your profession (will NOT be displayed/shared):
Address (will NOT be displayed/shared):
How did you come to know about UHO?

Remarks/comments:

Privacy policy: Please read here before signing. By submitting this form, you agree that your submitted information will be stored on our server. We will display publicly ONLY the following information: 'Name', 'Endorsed as', 'Country', 'Remarks'. Any other information (such as email address, phone, address) will NOT be displayed or passed on.