Nurse Practitioners & Physician Assistant Membership


Thank you for your interest in joining our growing group of like-minded health care professionals 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.

If your group is larger than 10, please contact us at
for special discounted rates.

1. Select Fee Amount

Total Fee

2. Group Administrator information

3. Payment information

Contributions are tax deductible.

4. The Independent Physicians Summit

Thank You for becoming a member. We would like to offer you free admission to The Inaugural Independent Physicians Summit:

February 8th & 9th

Hard Rock Hotel & Casino, Atlantic City

Who's donating

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