VDS 2026 Membership/Renewal Application

2026 Membership Application/Renewal

All fields with an * are required. Contact lknowles@ramdocs.org with questions.
Member Information:
Name:*

First NameMiddle NameLast NameSuffix
Degree:*
MD, DO, PhD, NP, etc.
Primary Email Address:*
Please enter the email address you'd prefer we use to contact you.
Cell Phone Number:
Format: (000) 000-0000.
YesNo
Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Practice Information:
Practice Name: *
Practice Phone:*
Practice Manager Name:
Practice Manager Email:
Employer Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Membership Categories
Membership Options:
- Active Member | $200; $205 if paying on-line | Board Certified/Board-Eligible Dermatologists
- Active Member Promo | $150; $155 if paying on-line | New members who join and register for the annual meeting
- Affiliate Member | $200; $205 if paying on-line | Non-dermatologist physicians or scientists engaged in dermatologic research and/or education.
- Group/Practice Membership | $500; $510 if paying on-line | Bundle up to 5 members
- Trainee | No Fee | Residents & Fellows
- Student | No fee | Medical Students
Pay onlinePay by check
Make checks payable to Virginia Dermatology Society and mail to:

Virginia Dermatology Society
2821 Emerywood Parkway
Suite 200
Richmond, VA 23294
Active Member - $200Active Member Promo - $150Affiliate Member - $200Group/Practice Membership - $500
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Active Member
This category includes physicians who are Board certified or Board eligible by the ABD or AOBD and are licensed to practice in the Commonwealth of Virginia or who are in active government service. This category includes practicing dermatopathologists who are Board certified or eligible as dermatopathologists but not Board certified or eligible as dermatologists.

$205.00



Active Member Promo
This category is only for new members who join and register for the Annual Meeting. This category includes physicians who are Board certified or Board eligible by the ABD or AOBD and are licensed to practice in the Commonwealth of Virginia or who are in active government service. This category includes practicing dermatopathologists who are Board certified or eligible as dermatopathologists but not Board certified or eligible as dermatologists.

$155.00



Affiliate Member
This category includes non-dermatologist physicians or scientists engaged in dermatologic research and/or education.

$205.00



Group/Practice Membership
Bundle up to 5 members. Membership is included for up to 5 Active physicians.

$510.00 Quantity



Trainee Member
This category includes physicians participating in residency or fellowship training programs in Virginia approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association.

$ Free Quantity



Student Member
This category includes medical students enrolled in accredited allopathic or osteopathic medical schools in Virginia.

$ Free



Test
$1.00



Total

$0.00
For Group Memberships, please list all names here. Please include each person's email address and cell phone.
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
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2026 Membership Application/Renewal

Member Information:

Practice Information:

Membership Categories