We are sorry to hear that you would like to deregister/cancel your application with the HPAC.
Thank you for your support to date and we wish you the very best for the future. Regarding deregistration, in order to securely process your request, we require you to complete this form in full.
Please ensure you have read the notice below before completing this form.
Deregistration while under investigation or with any active conditions on your registration:
In line with the terms and conditions of registration with us, deregistration will not prevent an investigation from going ahead, nor will it remove you from the register if you have any unspent cautions or suspension orders. Please note if HPAC receives credible evidence of misconduct, criminal behaviour or unsafe practice covered by the HPAC code of conduct regarding yourself as a clinician during your time on the register, you will still be subject to a full investigation by the fitness to practice panel. If the outcome of such an investigation is for a concern, suspension order or *struck-off notice to be put in place, your profile will be re-listed for public safety with the order in place.
Your HPAC ID card must be destroyed, you will be required to supply a face-up image of your HPAC ID card cut into four pieces.
Changing your mind:
If you change your mind and/or wish to discuss things further you can call us on 0208 004 8226 or email us at: email@example.com and we would be happy to help.
Once processed you may *re-apply to the HPAC register after 12 months have passed since your de-registration date.
*Struck-off notices remain in place in perpetuity.
*If you are de-registering during an investigation you may not re-apply for five years.