Membership Application Form Name Email Phone DOB Profession Address City / Town State PIN Area of interest or expertise Holistic & Traditional Medicine Preventive healthcare and wellness program Maternal and Child Health Environment Health and Sanitation Sexual Health and STD/HIV Interventions Family planniong and population stabilization Health education and awareness program Software technology solutions for health care Community development in urban and rural slum areas How would you like to contribute? Volunteering Financial Support Professional Expertise Other I hereby confirm that the information provided above is accurate and complete. I understand and agree to: 1. Adhere to the IIHH Code of Conduct and organizational values centered on holistic healthcare and community wellness. 2. Support IIHH's mission of providing accessible, affordable, and sustainable healthcare services to underserved populations. 3. Maintain confidentiality regarding sensitive health and organizational information as required. 4. Participate actively in programs, training, and community initiatives where possible. 5. Allow IIHH to use my information for membership communication and program updates. Agree Upload Your Photo Send
