New Membership Application

The application is two simple steps:

1. Application Information
2. Membership Dues Payment

To start enjoying the benefits of AMA membership, please fill out the registration form below. Make sure to fill out all blanks and to check your entries for typos. When finished, hit the submit button at the bottom of the page and you will be transferred to the payment page. Annual Membership dues for the Atlanta Medical Association are as follows: $300 Physician Member, $45 Resident Member, $100 retired and $10 Student Member.

If you are a current member and would like to update your membership information and/or submit your membership dues online, please click here.

---

Step One - Application Information

* Required

*First Name
Middle Name/Initial
*Last Name
*Username
*Password
*Confirm Password
*Email
Web Site URL
Gender		Male Female
Date of Birth
*Home Phone
*Mailing Address
*City
*State
*Zip
Practice Name
Office Phone
Office Address
City
State
Zip
Professional Degree		M.D. Other (Specify below)

Number of Years in Medical Practice
Primary Medical Specialty
Board Certified		Yes No
Medical School Attended
Year Degree Conferred
Graduate School
Class of
GA State Association Member		Yes No
NMA Member		Yes No

Professional Activity		Select One Clinical Practice Research Administration Retired Full Time Teaching Other (Specify Below)
Other
Special Category (check if applicable)
Active Duty Military
Resident / Fellow
Medical Student
Physician Member of a Chartered Medical Society in a Non-US Country
Non-Physician Doctoral Level Medical School Faculty
International Involvement		(specify below)

Primary AMA Medical Selection		Select One Allergy & Immunology Anesthesiology Basic Science Community Medicine & Public Health Dermatology Emergency Medicine Family Practice Internal Medicine Medical Administration Military Medicine Neurology-Neurosurgery Obstetrics & Gynecology Ophthalmology Orthopedics Otolaryngology Pathology Pediatrics Physical Medicine & Rehabilitation Plastic & Reconstructive Surgery Psychiatry & Behavioral Sciences Radiology Surgery Urology

AMA Experts and Speakers' Bureau
The AMA Talent Bank includes medical experts who may be called upon to represent AMA to the media, as speakers, and on advisory panels. Do you consider yourself an expert in a particular sub-specialty or have an interest in participating on our speakers bureau?

2010 AMA Dues Schedule		Select One Physician / Regular Membership** - $300 Retired - $100 Resident / Fellow* - $45 Medical Student - $10
- Membership in the Atlanta Medical Association is on a calendar years basis from January 1 through December 31.  Membership renewal is October 1 through December 31, but new members are encouraged to join at anytime during the year. - Only credit card payments are accepted online. Should you wish to pay membership dues with a personal or business check, please contact the AMA office at 404-607-8362 for an invoice. *denotes Associate membership. Associate members have no voting representation and may not hold office. **Pre-approval required

I Forgot my Password
Not registered? Register Now!