Thank you for your interest in joining our growing group of like-minded doctors who share a commitment to preserving our profession in New Jersey.
If you are joining as a single member, please fill out the form with the doctor's information. If you are filling out the form for two or more members, please have your office administrator fill out the form and we will send along a link that can be used by individual doctors to complete their registration.
We offer discounted membership rates to groups of 3 or more surgeons.
Please click on the total fee (in red) to continue to the next step in your registration process.
If your group is larger than 10, please contact us at firstname.lastname@example.org for special discounted rates.
Please note membership in the New Jersey Doctor-Patient Alliance is recurring and you will be automatically billed annually. If you do not wish to be automatically billed, you can opt out after you receive your confirmation email.