All disciplines within

Medical, Dental, Chiropractic, Optometry, Audio logy, Pharmacy

NEW OR RENEWAL MEMBERSHIPS

Member Information (Application) Form, Rev. 7/2010     (required annually)	download PDF	print copy and mail
Release of Liability Form   (required annually)	download PDF	print copy and mail
Professional Resume' (CV)   (required one time only)	complete On-line	submit via our website
Current Professional License    (required -- please remember to send us updates)	Mail legible copy with application
Include a check for $35, single, or $45, family and Mail.
Contact the coordinator of your Specialty -- Specialty Coordinators --and introduce yourself.   Our Coordinators are volunteers (non-paid) who hold down full time 'regular' jobs and may not have noticed your name appearing on the membership list.  We don't want to miss you, so please give us a call or send an email.

Licensed Professional Providers:

Chiropractic - Patricia Henthorn - docPatti@cox.net

Dental - Laurie Sarti - lauriebabe@cox.com

Medical - Gail Brown - gbflyingnp@cox.net

Optometry - Amy Crump - CrumpAmy@hotmail.com