Name *

First Name

Last Name

Mobile phone *

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Practice phone

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Practice address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Which of the following USMA benefits would you value most? Select all that apply.

Social and networking opportunities

Healthcare insurance products

Medical malpractice insurance products

Business insurance products

Wealth management support

Other practice support

Which of the following functions would you deem most important for USMA to engage? Select all that apply

CME products

Federal legislative advocacy

State legislative advocacy

Support open scientific discourse among physician peers

Instructive role in assisting physicians with practice development

Legal support: Model contract creation

Group negotiations support with third party payers, private management groups, hospitals, etc.

Protect physicians from professional backlash when publicly expressing viewpoints on developing medical issues

Influence the direction of medical education

Promote a positive public image of the medical profession through targeted media campaigns and public service announcements

Fill the void left by other physician groups

Serve as a place for physicians from all over the country to deliberate issues and chart a court for the profession's future

Provide data on practice macroeconomic trends and analytics