Fellow/Resident/Med-student-FSPM&R Membership Form

FSPM&R Membership Application

Florida Society of Physical Medicine and Rehabilitation
Who We Are
FSPMR is a Florida medical society, founded in 1962, representing the specialty of physical medicine and rehabilitation (PM&R), an organization exclusively serving the needs of PM&R physicians, also known as “physiatrists” (fizz ee at’ trist).

Core Value
The Florida Society of Physical Medicine and Rehabilitation serves its members by promoting our specialty and advocating public policy issues that relate to persons with disabling conditions. We will represent the interest of our members and their patients who have, or may develop temporary or permanent impairments or disabilities.

Our Mission
The Florida Society of Physical Medicine and Rehabilitation's mission is to promote and advance health and function through education and research in the field of Physical Medicine and Rehabilitation, in order to provide quality patient care and promote a person’s quality of life and improve functional outcomes.
PLEASE NOTE:

1. FSPMR offers FREE MEMBERSHIP for Fellows / Residents / and Med Students.

2. You will need to allow pop-ups and/or redirects when using this form
Name*

First NameMiddle NameLast NameSuffix
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
COUNTY ( Florida Counties)
Program Information Section
Program Name
Program Address

Street Address

Street Address Line 2

CityState

Zip Code
COUNTY ( Florida Counties)
Program Director *
Program Liaison
Personal and Professional Information
Florida Medical License Number
Fellow/Resident Section: Institution PGY
Choose an Option*

MDDONPOther
Membership Payment Section

Fellows - Residents - Medical Students - FREE FSPMR membership
Fellows - Residents - Medical Students: free to join FSPMR

Fellow/ Resident - $0Medical Students - No License $0
PLEASE NOTE: You will need to allow pop-ups and/or redirects when using this form
Questions?
email us at tjones@meyerresources.com
Should be Empty:

FSPM&R Membership Application

Program Information Section

Personal and Professional Information

Membership Payment Section