Member Application Form

Instructions

Now you have access to the InfoHub where you can connect with other members, access the Membership Directory, register for Conferences and renew your membership.

Select An Option

Practicing Physicians and Dentists: 1 year Membership $275 Annually

Practicing Physicians and Dentists: 1 year Membership: $275

Allied Health Professional/Retired Physician $100 Annually

Allied Health Professional/Retired Physician: $100

Health Professionals who are not doctors or dentists.

Affiliate/Resident $50 Annually

Affiliate/Resident: $50

For non-healthcare professionals wanting to support SAMS mission

Student $25 One-Time Fee

Student: $25

o Undergraduate Student

o Graduate Student

o Medical Student

Practicing Physicians and Dentists: 2 year Membership

Practicing Physicians and Dentists: 2 year Membership: $500

Practicing Physicians and Dentists: 3 year Membership

Practicing Physicians and Dentists: 3 year Membership: $700

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist

Member Application Form

STAY UPDATED