Join

If you are a physician, to join the SCMA, please complete the form below with your information and select "next" to submit payment. Residents, Students, and current members seeking to renew membership should click the applicable buttons below.

Renew Membership

Resident Members

Student Members

Physician Information

First Name

Middle Initial

Last Name

Email Address

Phone

Address Line 1

Address Line 2

City

Zip

Professional Background Information

Birthdate

SC License Number

Medical School Attended

Graduation Year

Residency Training Location

Residency Year Completed

Primary Specialty

Practice Information

Practice Name

Practice Address

Practice City

Practice Zip

Practice Phone

Practice Fax

Practice Manager Name

Practice Manager Email

Billing Information

Please note that billing address must match the address associated with your credit card for payment to go through.

Same as contact information

First Name

Last Name

Email Address

Phone

Address Line 1

Address Line 2

City

Zip

Payment Information

Offer Code

Amount Due: $

Card Number

Expiration (MM/YY)

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