• Upon completion you will be taken to a payment form to finalize your membership
  • Membership dues are $500.00/year
  • Resident Physicians can join for free
First Name
Last Name
Email Address (and username to login)
Password (at least 6 characters long)
Primary Phone Number
Cell Phone Number
Hospital Affiliation
Date of Birth
Subspecialty
Are you a Resident Physician?
Training Location
Years in training

Home Address

Address
City
Province
Postal Code

Work Address

Address
City
Province
Postal Code



Please click on the checkbox above to proceed.