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Florida Society of Ophthalmology - The EyeMDs

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Florida Society of Ophthalmology

Join the FSO

Active Members must meet the following criteria: degreed MD or DO from an accredited medical school, certified or eligible for certification by the American Board of Ophthalmology, and whose practices are limited to Ophthalmology. Payment must accompany application.

New Practitioner Available to new ophthalmologists in the first 3 years of practice. You must apply for New Practitioner Membership within one year of completing your residency or fellowship, and a dated copy of your residency or fellowship certificate must accompany your application. You must submit this type of application in print (download here).You may pay $850 with your application to cover the 3-year New Practitioner period, or pay $285 with your application and agree to be billed annually for the next two installments. After your New Practitioner period is over, you will be billed for Active Membership.

In-Training Members must meet the following criteria: degreed MD or DO who is serving in a recognized AMA/AOA approved ophthalmology residency training program or fellowship program (documentation must accompany this application).

Prefer not to pay or apply online? You can download a printable membership application here.

Please choose either:
Active Membership ($850.00)
In Training Membership ($0.00)
OR New Practitioner ($850.00/3yr) Must apply in Print

Referred by:
Referrer's Email:
Name (First, MI, Last)
Title
Gender
Medical License #
In-Training Completion Year
Date of Birth
Office Address Billing Address?
City State Zip
Phone Fax
Home Address Billing Address?
City State Zip
Phone Fax
Send Mail to:
E-mail
Subspecialty
(check all that apply)
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Are you a member in good standing of the Florida Medical Association? Yes No
If no, please explain:

Certified American Board of Ophthalmology Date:
If married, spouse's first name and last name

New Requirements by Federal Government: To receive blast faxes and blast emails from the FSO, please check the boxes below. Faxes and emails will only concern legislative alerts, special reimbursement notices, and meeting notices.

FSO/FOCUS Email List
FSO/FOCUS Blast Faxes

Payment Information

Active Membership$ 850.00
FOCUS Contribution
(Recommended)
$
For Eye Care Foundation
(Recommended)
$

Check this box if you would like to enroll in the Monthly Payment Option.

ABOUT MONTHLY INSTALLMENTS:

  • You may elect an installment option only with a credit card that is valid at least through December of 2014. After December 2014 you will be contacted for updated charge information prior to the expiration of your card.
  • By selecting to pay in installments, you agree to a set monthly charge of your card until such time as your voluntary contribution level changes or monthly payment is discontinued. Your payment amount is subject to annual adjustment based on future dues rate changes, with at least 30 days notice of any increase.
  • If your membership is renewed after 1/31/2014, installments will be charged retroactively as necessary, then charged in monthly increments to ensure that dues are 100% remitted by the end of the year.
  • Installments will be charged on or about the 15th day of each month.

Payment Method
Name on Card:
Card Number:
Card Expiration Date(mm/yy):
Card Security Code

I attest that the foregoing information is true and correct to the best of my knowledge and hereby authorize the Florida Society of Ophthalmology to obtain educational transcripts and verification of professional activities including associations and employment.

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