Become a Member or Renew Membership Name Last Name Address Mailing address Home Telephone Cell Phone Office Telephone Email address Membership category Select Membership Category A. Accredited Member Doctor of Medicine/Osteopathy/Veterinary/Dental/PhD Accredited Member - $50 Accredited Life Member - $500 B. Associate member A healthcare professional not included in the accredited category who possesses qualifications recognized by the professional governing body of such profession in the United States of America. Associate Member - $30 Associate Life Member - $300 C. STUDENT/RESIDENT/FELLOW MEMBER A healthcare professional still in a recognized training program or a student in a healthcare field. Student/Resident/Fellow Member - $0 Date Input this code: Download and mail in application