Clinic Membership Application Form Logo
  • ACPOC Clinic Membership Application

    To apply for membership please complete all questions and submit payment Membership Dues (10% discount rate): Physician: $285($256.50) Non-Physician: $175($157.50) Corresponding: $120($108)
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          Physician Membership with 10% discount
          $256.50
            
          Non-Physician Membership with 10% discount
          $157.50
            
          Corresponding Membership with 10% discount
          $108.00
            
          Total
          $0.00

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