Alliance Membership Application

If you are a spouse/partner of a physician or physician assistant, you can now become a member of the Oregon Medical Association!

We are looking forward to your membership. Please fill out the secure application below. Note: you will be asked to pay for your membership online once you submit your application.

PROFESSIONAL INFORMATION
ALLIANCE INFORMATION

PAYMENT

Payment Method (if paying by check, please make payable to Oregon Medical Association and mail to 11740 SW 68th Parkway, Suite 100, Portland, OR 97223)

Please make check payable to Oregon Medical Association and mail to 11740 SW 68th Parkway, Suite 100, Portland, OR 97223


AGREEMENT

I authorize the OMA and its affiliates to communicate member benefit information by e-mail.

OTHER

If you have any questions, call OMA at (503) 619-8000 or send an e-mail to oma@theOMA.org.

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