Membership is contingent upon the Central Florida Medical Society acceptance of the membership application. The endorsement, deposit or negotiation of an  applicant’s check does not guarantee  acceptance of membership by CFMS.  Checks received will  routinely be deposited without a determination of the propriety of payment. 

Applicants who are not  accepted to membership will  receive a refund for the amount submitted.
By submitting your application, unless other disclose, you confirm

1. You are in good standing in the community, and
2.  Have not been convicted of fraud or a felony within the past 5 years.
3.  Do hereby grant permission for all photographs taken of you during your membership and association with CFMS at any function or event to be used for either publicity or advertising.     

Application Information

Name
  
Email
  
Web Site URL
  
Gender
  
Mailing Address
  
City
  
State
  
Zip
  
Practice Name
  
Office Phone
  
Office Address
  
City
  
State
  
Zip
  
Professional Degree
  
   
Number of Years in Medical Practice
  
Primary Medical Specialty
  
Board Certified
  
Licensure Number(s)
  
State(s)
  
Expiration Date(s)
  
Medical School Attended
  
Year Degree Conferred
  
Graduate School
  
Class of
  
FL Medical Association Member
  
NMA Member
  
Hospital Affiliation/Privileges:
  
Special Category (check if applicable)
    
Active Duty Military
  
Resident / Fellow
  
Medical Student
  
   
Primary AMA Medical Selection
  
2007 CFMS Dues Schedule
  
- Membership in the Central Florida Medical Society is on an calendar years basis from January 1 through December 31.  Membership renewal is October 1 through December 3, but new members are encouraged to join at anytime during the year. Should you wish to pay membership dues with a personal or business check, please contact the CFMS office at 407-677-8032 for an invoice.