I hereby apply for membership in the MPCMS, I agree to abide by its ByLaws and the Principles of Medical Ethics. I also agree to cooperate fully with any grievance or peer review investigation conducted by the MPCMS Medical Review Committee and acknowledge that failure to do so may constitute grounds for disciplinary action.
If you wish to pay by check, print off form and return form with application fee to:
Marion-Polk County Medical Society
4985 Battle Creek Road SE, Suite 130
Salem OR 97302
Call us at 503-362-9669 if you have any questions.