Allied Membership Application

Allied membership in the Ohio Osteopathic Association is limited to:
(1) Ohio licensed Advance Nurse Practitioners, Physicians Assistants, Psychologists, and other non-physician clinicians who are currently employed with an active member of the OOA, contribute to the practice of that member, and support the goals and objectives of the OOA.
(2) Medical Doctors (MDs), Doctors of Podiatric Medicine (DPMs), or Doctors of Chiropractic (DCs), who are licensed in Ohio and support the mission of the OOA and subscribe to its code of ethics. To receive discounts and benefits of the OOA Business Partners program, MDs and DPMs must become Associate members and pay dues required of Associate Members.
(3) Doctoral and other non-doctoral personnel holding teaching, research or administrative positions in Ohio accredited hospitals and/or colleges.
(4) Administrative employees of this association, accredited hospitals or colleges, affiliated organizations and district academies.
(5) Any other professionals as determined by the Board of Trustees.

CONTACT INFORMATION

First Name:
Last Name:
Position/Title:
Employer:
Address:
City State Zip
Phone: Fax:
Email:

PRACTICE TYPE / ANNUAL DUES

Please indicate your Allied Membership Category below, and corresponding dues amount.
Level 1 - Doctors: Medical Doctors (MDs), Doctors of Podiatric Medicine (DPMs), or Doctors of Chiropractic (DCs), who are licensed in Ohio $150.00
Level 2 - Non-Physician Clinicians: Ohio licensed Advance Nurse Practitioners, Physicians Assistants, Psychologists, and other non-physician clinicians who are currently employed with an active member of the OOA.$100.00
Level 3 - Hospital Teaching/Research: Doctoral and other non-doctoral personnel holding teaching, research or administrative positions in Ohio accredited hospitals and/or colleges.$35.00
Level 3 - Administrative: Administrative employees of this association, accredited hospitals or colleges, affiliated organizations and district academies.$35.00
Level 3 - Professional: Any other professionals as determined by the Board of Trustees$35.00

Dues Amount

 
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