2023 RMGMA Membership Renewal Form

Name*

First NameLast Name

Organization:*

Position/Job Title:*

Title

E-mail*

example@example.com

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Cell Phone:

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How would you like to pay your membership dues?*

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Paying by check options:

Active Member (Dues = $50) ----- Any individual employed in a management capacity by an entity providing health care services (including, but not limited to physician practices whether or not affiliated with an accredited graduate medical education or medical school program, federally qualified health centers or other community health centers providing physician or health care services, or ambulatory surgery centers, diagnostic imaging centers, home health agencies or similar providers)Affiliate Member (Dues = $150) ----- Any individual who is employed by, or an owner of, an entity providing products or services to health care providers (including, but not limited to, health care vendors or similar providers, insurers or physician network administrators). An affiliate member shall not have the right to vote or to serve as an elected director.Student Member (Dues = $25) ------- Any individual enrolled as a full-time student in a healthcare or business-related degree program at an accredited institution of higher learning(including, but not limited to, community colleges, technical colleges or universities or fellowship or post-graduate programs). A Student Affiliate Member shall not have the right to vote or to serve as a Director.Lifetime Member (Dues = $25) ----- Any individual who has been an Active Member in previous years and has fully retired from the field of health care management. A Lifetime Member shall not have the right to vote or serve as a Director.

If paying by check, please make payable to RMGMA and send to:

Attn: RMGMA Membership Dues

2821 Emerywood Parkway, Suite 200

Richmond, VA 23294

My Products

ACTIVE MEMBER$60.00

Any individual employed in a management capacity by an entity providing healthcare services (including, but not limited to physician practices whether or not affiliated with an accredited graduate medical education or medical school program, federally qualified health centers or other community health centers providing physician or health care services, or ambulatory surgery centers, diagnostic imaging centers, home health agencies or similar providers).

AFFILIATE MEMBER$160.00

Any individual who is employed by, or an owner of, an entity providing products or services to health care providers (including, but not limited to, health care vendors or similar providers, insurers or physician network administrators). An affiliate member shall not have the right to vote or to serve as an elected director.

STUDENT MEMBER$35.00

Any individual enrolled as a full-time student in a healthcare or business-related degree program at an accredited institution of higher learning (including, but not limited to, community colleges, technical colleges or universities or fellowship or post-graduate programs). A Student Affiliate Member shall not have the right to vote or to serve as a Director.

LIFETIME MEMBER$35.00

Any individual who has been an Active Member in previous years and has fully retired from the field of health care management. A Lifetime Member shall not have the right to vote or serve as a Director.

Total $0.00

Payment Methods

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2023 Current Member Dues Renewal Form

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