Physician Membership Application

To apply for physician membership, please complete all fields

Application Information

Your MHA Physician Membership includes a paid membership to AAPL. If you are already an AAPL member, the MHA will pay your AAPL membership dues upon your next renewal with AAPL.

Affiliated Organization Information

To become a Physician Member of the MHA, you must be affiliated with an MHA Member Organization/Hospital.

Assistant Information

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