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Professional Membership

This registration form is for new Professional Members to create accounts and pay membership dues. If you already have a Professional Membership account and would like to pay your renewal fees, please sign into the website first.

Medical Doctor & DO
Membership Price

$95

Cardiac Care Associate/Trainee
PA, NP, RN, Fellow
Membership Price

$65

Cardiac Care Support Staff
Social Worker, Cardiac Sonographer, and MRI/CT tech
Administrator, Program Manager/Coordinator
Membership Price

$50

ACHA medical professional members are entitled to the following benefits:

A complete sample of all ACHA materials.
Discount on bulk orders of all of ACHA’s print education material orders, such as ACHA’s Personal Health Passport and ACHD Travel Directory.
Access to ACHA events for medical professionals.
Opportunities to participate in ACHA medical professional initiatives and network with your peers.
ACHA’s bimonthly e-newsletter, Heart Happenings.
E-mail updates on ACHD/CHD professional issues.
E-mail updates on meeting and training opportunities.

Account Information

Type of Membership

Email Address ^*

Password ^*

Confirm Password ^*

* Required fields

Your Information

Salutation

First Name ^*

Last Name ^*

Address (1) ^*

Address (2)

City ^*

State/Region ^*

Zip/Postal Code ^*

Country ^*

Phone Number ^*

Gender

Birth Date ^*

Additional Information

Would you like your annual membership to renew automatically? ^*

Please tell us which ACHD program you are associated with? ^*

I am interested in speaking engagements

I am interested in information to let my patients know about ACHA programs

I DO NOT wish to receive communication from ACHA through email

I DO NOT wish to receive communication from ACHA through postal mail

I have some ideas of how I can help ACHA or how ACHA can help me or my practice. Please contact me

Name of person to send ACHA information to:

Email of person to send ACHA information to:

We want to hear from our members! Please provide your suggestions, ideas, webinar topics, etc. Any questions?