Ohio Obesity Society Membership Registration
Thank you so much for your interest in membership. Please tell us a little about yourself! This information is not shared with anyone outside OOS staff without your permission, but will help us greatly in building a better community.
Name
*
First Name
Last Name
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State
Zip Code
Phone Number
-
Area Code
Phone Number
Type of Provider
Please Select
Physician
Surgeon
Nurse Practitioner
Physician Assistant
Dietitian/Nutritionist
Pharmacist
RN
LPN
Medical Assistant
Exercise Physiologist
Psychologist
Other
Employer
Help us build our society. Please check all that apply...
I would also be interested in writing or providing other content
I would be interested in speaking at an event
I would be interested in advocacy
I would be interested in obesity education
I would be interested in volunteering in other ways
I would like to be a member, but I am not interested in helping out in other ways at this time
Membership Level
prev
next
( X )
Physician Member
(
$
50.00
for each
year
)
Non-physician Member
(
$
25.00
for each
year
)
Student
(
$
Free
for each
year
)
Submit
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