pams form

Type of Membership
You must be a Physician to be considered for a regular PAMS membership. Are You an MD, DDS, DPM, MD/PhD, Medical Student, DVM or DO?

Name of Medical School *

Name of Medical School*

Year of Graduation *

Residency and Fellowship *

Specialty and Appointments

Specialty and Appointments

First Name of Spouse
Required only for couples discount

First Name of Spouse

Yearly Membership Dues
After Submitting the form, you will be redirected to PayPal where you will pay the yearly membership dues with any major credit or debit card, subject to 4% surcharge. Alternatively, avoid the surcharge, and send a check.

Membership and included PayPal Fee

Electronic Signature

Purchase Membership for your Employees

Price: $175.00

Membership Application