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Membership Application
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Membership Application

Note: This form is for new program applying for FPIN Membership. If you need assistance accessing member content on the website, please contact: membership@fpin.org.

1. Program Director/Residency Coordinator/Faculty in charge of Scholarly Activity completes the following form.

2. The Membership Manager will contact you within 48 hours to set up a phone call.

3. Submit your FPIN Implementation Plan/Program Profile List.

4. Submit a letter of support for FPIN Membership from your Department Chair.

5. Once steps 1-4 have been completed and approved, your FPIN Membership will be activated and the invoice will be sent.

6. You will receive more information on completing steps 3-4 during the initial call with the Membership Manager. Questions? Contact: membership@fpin.org

 

  
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Family Physicians Inquiries Network

401 West Blvd. North, Suite D
Columbia, MO 65203

Hours: 10:00 AM - 4:00 PM CST
Tel: (573) 256 - 2066
Fax: (573) 256 - 2078
E-mail:info@fpin.org