FICS Global Chiropractic Provider Pool (GCPP)

FICS Global Chiropractic Provider Pool

Date of entry(Required)

Full Name (As shown on your passport)(Required)

First Last

Passport Expiration Date

Preferred First name

Email(Required)

Enter Email Confirm Email

Nationality / Citizenship

Date of Birth(Required)

Gender

Phone with International country code. Example 61 417 348 348 or 1 6212 1225 220

Time Zone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Professional Credentials and Lanauages

Professional Title(Required)

DC, ICSC, CCSP, PT, ATC etc.

University/College of Chiropractic Degree(Required)

Name of University/College.

Date

If you are yet to graduator, SELECT year and month you expect to graduator. You can choose any day as a guide.

Is your Chiro License in good standing?(Required)

Date of Expiry Chiropractic Licensure

This field is optional, as not all countries require a license. However, if your country does require one, please provide the date your license was issued."

Other Professional Licensure (s) held

What Languages do you speak? Select all.(Required)

Add other Languages not listed

There are an estimate of 7,000 different languages spoken around the world. If your language is not listed above please add here.

If English is your second language, please rate your level of spoken English proficiency.

FICS Engagement & Experience

Have you completed your ICSC?(Required)

If you are currently enrolled in the ICSC and have not yet completed the program, please indicate which components you have already completed.

Do you hold ICCSP or ISSCD

If you hold one of these accreditation you will need to update to the ICSC to work at international games. Read about the expedite pathways on the FICS website. https://fics.sport/education/ or reach out to us at admin@fics.sport.

ICCSD

ICCSP

Membership with FICS please select.(Required)

https://fics.sport/membership-ncsc/ FICS boasts a significant international membership base, including 31 current NCSCs, several educational institutions, and affiliated organizations. Please select your membership type.

EVENTS: Have you worked at games with FICS before?(Required)

WHAT EVENTS have you worked at to date(Required)

Local State Representative Teams

National Sporting Teams

International Sporting Team with my country

International Individual Sports

International Events with FICS

Olympic Training Centres

What type of Sports have you got experience with?

The below are some of the International Sporting Federations which FICS work with. Select all the events you have had experience working at.

How many events have you worked for FICS in the last four years?(Required)

Do you hold Malpractice Insurance(Required)

Do you have International travel experience?(Required)

Which are the best travel months for your schedule(Required)

Travel Expenses - Select the areas you are willing to travel to.

You will be required to cover your own flights to and from the event however once there, your accommodation, pick up from airport and meals during the event will be covered. A lot of doctors use the opportunity to take in the countries sites either side of an event and you can still use the event as a tax deduction.

Select All

Africa

Antarctica

Asia

Australia

Europe

North America

South America

Is there any months in the year you CANNOT travel

(cannot travel in June or during the school year)

Travel Costs

Please acknowledge the following by ticking the box below: If selected for an event, I understand that I am responsible for covering my own travel expenses to the event location. This includes costs such as flights and travel insurance. However, I acknowledge that once I arrive, ground transportation to the accommodation, lodging, and meals during the event will be fully covered by the organisers.

I have read and understand the travel and expense responsibilities outlined above.

Chiro Treatment Table Availability

Many international events require attending doctors to provide a treatment table. While FICS does its best to source tables locally, there are occasions when additional support is needed. If you have a portable table you are able and willing to travel with, your assistance would be greatly appreciated.

I have a portable treatment table and am willing to travel with it if needed.

I do not have a treatment table but open to travelling with one should the time come I own one.

I am unable to travel with a table

Leadership

Leadership roles offer a chance to grow professionally, contribute at a strategic level, and help shape the success of your team. Indicating your interest signals your interest to take on greater responsibility.

Are you interested in taking on leadership opportunities, such as Team Lead, Research Lead, or similar roles?

Upload Evidence

If you have already provided FICS your evidence through the ICSC process or working at events there is no need to upload again.

Evidence CV

If you have not already provided this information to FICS in the last 2 years please upload a current CV

Accepted file types: pdf, docx, doc, jpg, png, txt, odt, csv, Max. file size: 2 GB.

Evidence Chiropractic Degree

If you have not already provided this to FICS via your ICSC process or working at event please upload your license.

Accepted file types: pdf, docx, doc, jpg, png, txt, odt, csv, Max. file size: 2 GB.

Evidence - Malpractice Insurance

You will need to hold your own personal Malpractice insurance to work at events. Please upload a copy of your current insurance.

Accepted file types: pdf, docx, doc, jpg, png, txt, odt, csv, Max. file size: 2 GB.

Passport

Please upload a clear image of the photo page of your passport. Kindly note that for international travel, your passport should typically have at least six months of validity remaining beyond your intended date of travel.

Max. file size: 2 GB.

Professional Photo

Please upload a recent head-and-shoulders photo of yourself, taken within the last five years. This image will be used for your international event accreditation.

Max. file size: 2 GB.

Submission

By hitting submit you agree to follow FICS' Code of Conduct, Ethics Policy, and Clinical Protocols? You will be required to read and sign off on all FICS policies before attending an event. I the undersigned understand that the information I have provided will be stored securely by FICS for the purpose of volunteer selection, credentialing, and communication in compliance with the GDPR privacy and storage of data policy FICS have in place. I acknowledge that the data I provide to FICS may be processed and securely stored using third-party platforms, including cloud-based systems that may be hosted outside of Switzerland, provided that appropriate safeguards are in place. I understand that I may request access to, correction of, or deletion of my personal data at any time by contacting FICS administration. FICS processes this information based on my consent, which I may withdraw at any time. If I choose to withdraw my consent for my data to be stored, or exercise my right to be forgotten, FICS will make reasonable efforts to delete my personal data from all systems under its direct control and ensure it is not used again. However, I acknowledge that complete removal may not be possible from materials or systems outside of FICS's control, such as already printed publications, website backups, or data shared with third parties (e.g. Games Organisers) for events I participated in.

View FICS Code of Ethics.

FICS requires all volunteers associated with FICS to observe high standards of integrity and honesty, and to act with care, diligence and fairness in all our business activities. All our interactions with stakeholders and the wider society should be conducted in an ethical and proper manner. To that end, all of us must comply with this code and all supporting policies, the laws and regulations of all countries in which we operate, and with all applicable national and international codes. Read FICS Code of Conduct.

I agree to the storage and processing of my personal data by FICS for the above purposes only.(Required)

I provide my permission to use this information I have provided for the purposes of volunteering for international events with FICS

Name

This field is for validation purposes and should be left unchanged.