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Membership Signup

Once you submit the form below, you will be prompted to pay using your Visa, MasterCard or American Express. Your credit card will be charged and your application will be pended until approval from National AMBA and verification of your AMBA membership is made. A confirmation email will be sent to you welcoming you to the chapter.

Thank you for supporting your Local Chapter

Dues: $35.00 a year ( other fees may apply for Seminars/Training/Special Events etc).

REGISTRATION FOR MEMBERSHIP

Business Name

Email Address

AMBA Member #

AMBA Membership Type

Select One - Membership Status

Full Name

Address

City

Zip

Business Phone

Mobile Phone

Fax

Website

Are you just started out?

Enter the specialty areas you are experienced in:

Do you currently have clients?

What Specialties would you like to learn more about?

List any other memberships or associations you are a member of

What Practice Management Software are you using?

What other practice management software's are you familiar with?

What expectations do you have from your chapter membership?

Please feel free to post any comments or concerns here

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Once you hit submit you will be taken to a page to choose your method of payment. (MasterCard, Visa, or American Express) Please submit this form only once!

Rules of the Chapter:

1. You are obligated to vote in 75% of all polls posted in the groups area

2. You are obligated to join the yahoo groups area

3. You are obligated to vote in all officer elections

4. You must be a National AMBA member and keep your membership current through your Chapter membership

5. Must attend at least 3 meetings per year. Penalties include non-renewal of membership.

You MUST be a member of AMBA (American Medical Billing Assoc) to participate in the Local Chapter. We will verify your AMBA membership when you join or renew your Chapter membership. You are required to maintain your AMBA membership to participate in the Local Chapter. Please refer to Chapter Hand book for details.

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