OPNA Membership Request Form

CFCA-OFCA Membership Request Form

Please Submit a Request to Become an CFCA-OFCA Member!
In order to purchase a yearly membership to the Canadian Foot Care Association-Ontario Foot Care Association, we need to confirm eligibility.

First Name*

Last Name*

Email*

Phone Number*

Address*

Unit/Suite/Apt

City*

Province*

Postal Code*

Please upload confirmation of completion of your Podortho Foot Specialist Certificate or equivalent Foot Care Certification with Podortho Foot Specialist Online Certificates. You are required to send in proof of Certificate and it will be verified by our Membership Director.

Word Documents or PDF Only

Please Enter Your Regulatory College Registration Number*

(College of Nurses of Ontario)

Please list proof of practice liability insurance

(Separate with a comma)

List any other associations you're registered with

(Separate with a comma)

Independent Practice Information*

(clinic name, address, contact info, etc.)

Would you like to be added to our find a Pordortho Foot Specialist tool listed on our OFCA website?

Yes

I also hereby acknowledge that the membership fees for the Ontario-Canadian Foot Care Association are non-refundable and non-transferable.
View Member Cancellation Policy*

I Acknowledge / Consent

Do you consent to completing your Podortho Foot Specialist Core Competencies within 12 months of your membership registration?

I Acknowledge / Consent

This field should be left blank

CFCA-OFCA Membership Request Form

Podortho® Foot Specialist Members Enjoy the Perks!

Become a Member for amazing benefits

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