PSO Membership - Executive Membership

PSO Membership

$350.00

SKU: ExecMemb

Membership is open to professionals who have (or are working toward) an academic degree or clinical license or certification with an interest in pain treatment and an ability to contribute to the society's purpose. Membership implies a desire to attend and participate in Society affairs for at least one year. This informal requirement is made to insure continuity and stability of the organization and the ability of the member to make a contribution by their presence. Members are encouraged to participate in the Societies’ educational presentations.

If you are interested in submitting Directory information, please download the form here: http://www.painsociety.com/docs/directory.2011.pdf

If you have any questions, contact the Pain Society Eugene Office at: 541-345-7300 or email us at info@painsociety.com

Price: $350.00

First Name: *

Last Name: *

Title: *

Other or Additional Title(s):

Enter a title not found on our list or additional titles you may have

Office Address: *

Office City: *

Office State: *

Office Zip Code: *

Office Phone: *

Office Fax:

Cell Phone:

Home Phone:

Email: *

The e-mail you enter will be used to send conference notifications and future PSO event information. You may unsubscribe from PSO email lists after submission

Business Website:

License(s) or Certification(s) Held: *

Please include up to 4 license(s) or certification(s) held

Directory Listing: *

PSO offers members a digital directory entry on our website for easy referrals and access. Please indicate if you would like the contact information listed to be included in our directory.

Areas of Specialty/ Areas of Special Interest in Pain:

Awards, Honors, Specialized Training:

Professional Affiliations (Please spell acronyms out):

Please list up to 4 Professional Affiliations

Describe your Clinical Practice:

If you would like to include a description of your practice, please email it to the PSO office info@painsociety.com

Additional Comments:

If you have any other comments about your registration

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PSO Membership - Executive Membership