Application

Both paper and electronic Membership Applications are accepted. If you would like to pay by check and mail in your application, you can download our 2019 Membership Application.

If you prefer to pay by card and submit your application online, please submit the below form.

Membership Application

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

CONTACT INFORMATION

First Name *

Middle *

Last Name *

M.D. or D.O. *

Date of Birth *

Email *

Specialty *

Years at Location *

Practice Name *

Office Address *

Office Address

City

State/Province

Zip/Postal

Office Phone *

Office Fax *

EDUCATION

Pre-Medical School(s) *

Year Graduated *

Medical School(s) *

Year Graduated *

Current Hospital Affiliations *

CERTIFICATION

Are you certified by American Board of Orthopaedic Surgery? *

Year of Certification *

Are You Board Eligible? *

I am a:

Yearly dues for the Orthopaedic Society of Oklahoma are $350.00 for Orthopaedic Surgeons in Practice, $175 for Associate Members (Other Specialties & Mid-Levels), and free for Residents/Fellowships. Please press the continue button to pay by card (processed by PayPal). You will then be redirected back to our homepage.

CONTACT INFORMATION

EDUCATION

CERTIFICATION

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