SCHMA Membership RegistrationSCHMA membership page

SCHMA Membership Registration

ADDRESS INFO
Select a Membership Type If you have questions, please contact ASKUS@SCHMA.org or call Cindy Ott (800-804-7754).	Chapter Membership ($125.00) Active Chapter membership is limited to those individuals who are affiliated with a health care organization that provides patient care and works in a management/supervisory capacity. Affiliate Membership ($300.00) Affiliate membership is available for those individuals who provide products or services to health care organizations, and who have not joined as a corporate member. Member-at-Large ($125.00) Member-at-Large is limited to those members who are affiliated with a healthcare organization that provides patient care and works in a management/supervisory capacity. Members-at-Large are those individuals who qualify for active membership but who are not members of a local chapter. Corporate (Bronze) Membership ($2000.00) Includes membership in 2 local chapters. Please indicate below the chapters you wish to join. Corporate (Silver) Membership ($3500.00) Includes membership in 5 local chapters. Please indicate below the chapters that you wish to join. Corporate (Gold) Membership ($5000.00) Includes membership in all local chapters. Test ($0.35) This is for test purposes only, and will not provide any subscription benefits
Select a Payment Method If you wish to mail a check, choose "Offline Payment".	Pay by Check - Pay by Check Pay by credit card - secure credit card payment
Your Name Your First & Last name
Your E-Mail Address A confirmation email will be sent to you at this address
Choose a Password Must be 4 or more characters
Confirm your password Enter password again
Choose Chapter Name Corporate members may choose two (hold down CTRL key).
Name of Practice/Business Please enter your Practice or Business Name
Your Title Enter your title, if any.
Business Phone Please enter your business phone number
Other Phone Please enter a secondary phone number (optional)
Fax number
Your Specialties Indicate any Specialty or Specialties you represent
Your Certifications Indicate any certifications you have and through which organization
MGMA Member? Are you a member of the National Medical Group Management Association (MGMA)?
Referred by How did you hear about us?
Street
City
State
ZIP
Country

CONTACT US!
If, at any time you have any questions about your SCHMA membership,
please contact Cindy Ott, Heather Black or Harriet Oster at ASKus@SCHMA.org.
Additional contact information can be found at the SCHMA website

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