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Membership information

Interested in Joining the Ohio Orthopaedic Society?

Download the "Invitation to Membership in the Ohio Orthopaedic Society" before applying.

Become a Member

At the 2007 Ohio Orthopaedic Society Annual Meeting, the members voted to allow Ohio Osteopathic Orthopaedic Surgeons and Residents to become members of the Society. Please note that the membership application and benefits of membership have been redesigned to reflect this change in the By-Laws.

To View the OOS By-Laws click here.

MAIL-IN APPLICATION

   arrowOhio Orthopaedic Society Membership Application

 

ONLINE APPLICATION

Do not leave fields blank, please mark them with "N/A"

Contact Information:
First Name
 Middle
 Last Name
Check One: M.D.
D.O.
OFFICE INFORMATION:
Street
 City
ZIP
County
Telephone
Fax
Email  
 
HOME ADDRESS:
Street
 City
ZIP
County
 Spouse Name (optional)
 
EDUCATION:
PRE-MED
School(s)
Degree
 Year Graduated
 
MED-SCHOOL
School(s)
 Year Graduated
 
INTERNSHIP
Place(s) Interned
 Dates
 
POST-GRADUATE WORK ; FELLOWSHIP ; ORTHOPAEDIC RESIDENCIES ; ETC..
Workplace(s)
 Dates
 
MISCELLANEOUS INFORMATION
Are you a member of the American Board of Orthopaedic Surgery?
YES NO Please list year of certification
     
Are you board eligible: YES NO  
 
Are you certified by the American Osteopathic Board of Orthopaedic Surgery?
YES NO Please list year of certification
     
Are you board eligible: YES NO  
 
I have been practicing in my current location for years
Local Hospital Staffs:
 
Institutional Connections:

PLEASE REVIEW BEFORE SUBMITTING THIS APPLICATION
As a practicing physician residing and/or practicing within the State of Ohio, and whose chief interest is confined to the practice of orthopaedics, I hereby make application for membership in the Ohio Orthopaedic Society, and submit the following information in support of my request for affiliation.

Please make sure you have filled out all sections of this form and double checked for accuracy.


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