ACOEP Retired Member Application

Thank You for Applying for Retired Membership

With Retired Membership, your annual membership dues will be decreased to $500 per year. Please complete the application below to confirm that the criteria apply to you. Note: Retired Membership rates go into effect during the next dues cycle after the granting of this status.

About Retired Membership

Retired membership is designed for individuals who would otherwise qualify as Active members and who have formally ended their emergency medicine practice. Your application will be reviewed by the Member Services Committee. If the committee recommends approval, the recommendation will be submitted to the Board of Directors.

Bylaw Wording

(e) Retired Member. Retired membership may be granted, upon application to the Member Services Committee to any individual who would otherwise be eligible to be an Active member, but who is officially and permanently retired from the practice of emergency medicine. This recommendation must be approved by the Board of Directors.

What This Means for You: You must meet Active eligibility criteria and be officially and permanently retired from the practice of emergency medicine. The Member Services Committee reviews applications, and the Board of Directors provides final approval.

Application Review Process

Applications are reviewed four times per year according to the following schedule:

November 1
February 1
May 1
August 1

Applications received after these cutoff dates will be reviewed in the next review cycle.

Each application will first be reviewed by the Membership Committee and then forwarded to the Board of Directors for final approval at their next scheduled meeting. Once the Board votes to approve your application, you will receive formal notification of your membership status change.

If we have any questions about your submission during this process, we will reach out directly.

Optional Details to Help Review

To assist the committee in reviewing your application, you may choose to provide additional information about your professional background and retirement status. These details are optional but can help expedite verification and approval.

Last primary employer or group
Last title or role
Years in practice
Any notes or additional context for the Member Services Committee

Applicant's Full Name*

First NameLast Name

Email*

example@example.com

ACOEP Membership Join date: *

Date you became officially and permanently retired from the practice of emergency medicine:*

Since that date, have you performed any compensated clinical emergency medicine work?*

NoYes, please describe hours, dates, and setting below

Do you perform any uncompensated clinical work, telemedicine, or consulting in emergency medicine*

NoYes, please describe below

Current medical license status*

I attest that I am officially and permanently retired from the practice of emergency medicine.I attest that the information provided is true and accurate.I understand the Member Services Committee will review this application and a recommendation must be approved by the Board of Directors.

Anything else the Membership Committee should know?

Signature*

Date*

Date