Member Registration Form

Please complete the Member Registration Form below.

There are multiple classes of membership in the Association: general membership, student, retired, lifetime, and affiliate. All members of this organization will be encouraged to be members of the national association, AMDA – The Society for Post-Acute and Long-Term Care Medicine.

a. General: Membership in FMDA may be granted to any physician who holds the position of medical director, or a physician, advanced practice nurse, pharmacist, or physician assistant who has an interest in or who provides medical services in full or in part in PA/LTC. Members in this classification shall be entitled to a vote and the eligibility to be a member of the Board of Directors.

i. Retired: Includes physicians, advanced practice nurses, pharmacists, and physician assistants who are fully retired.
ii. Lifetime: Includes physicians, advanced practice nurses, pharmacists, and physician assistants who continue to work and are not retired.

b. Allied Health Professional Relations Committee: Health care practitioners who provide essential services to patients in the PA/LTC setting are eligible to join, including dental professionals, podiatrists, opticians, psychologists, therapists (PT/OT/ST), etc. Committee members are non-voting and maybe appointed by the Board of Directors to serve on other FMDA committees.

c. Organizational Affiliates: Are organizations in the medical, regulatory, or political fields of PA/LTC wishing to promote the affairs of FMDA. They include vendors, other professionals, and organizations.

d. Students: Student membership is available to physicians/PAs/
pharmacists/NPs-in-training, including interns, residents, fellows, and to premedical students and any person engaged in graduate medical/NP/PA education in the U.S. Student members shall have all FMDA privileges except they shall not be eligible to vote or hold office.