Become a Member Become a Member First Name * Last Name * Select One * Not ApplicableMDDODDSDMDMSPARNNPStudent Membership * Active Membership($250/year) Young Physician ($125/year) less than 2 year in practice Part-Time Physician ($125/year) Retired Physicians($100) Student (Medical, Dental or Allied Health)(Free) Resident/Fellow($50) Associate (Residing in US but not licensed to Practice) ($100) Allied Health Professional($75) Email * only for use of AMWPA to correspond with you, it will not be displayed anywhere on our website. Personal Phone Number * only for use of AMWPA to correspond with you, it will not be displayed anywhere on our website Speciality * Not ApplicableAllergy & ImmunologyAnesthesiaAsthmaCardiologyChiropractorCornea Consultant of Texas Ophthamologist/eye doctorDentistDermatologyEmergency MedicineEndocrinologyFamily PractiseInternal MedicineInternistNephrologyNeurologyGynecology/ObstetricsOncologyOphthalmologyPathologyPediatricsPsychiatryRheumatologySurgery Medical School Year of Graduation Residency Training Institute Fellowship Training Institute New Patients Yes No Office/Work Address * Office/Work Address Office/Work Address Office/Work Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Office Phone Number Additional Information Submit If you are human, leave this field blank.
