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—Please choose an option—New MemberMedical StudentFellow/ResidentJoin the Directory
[group General]
First Name *
Last Name *
Phone *
Email *
[/group]
[group NewMedFel]
Address
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[group FellowResident] Residency/Fellowship —Please choose an option—ResidentFellow [/group]
Medical School
Medical Degree —Please choose an option—MDDO
[group NewFel] Year of Graduation —Please choose an option—20222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970 [/group]
[group MedicalStudent] Current Year —Please choose an option—1st2nd3rd4thN/A [/group]
[group MedFel] Internship/Residency [/group]
[group MedFel] Internship Years [/group]
[group MedFel] Graduate School [/group]
[group MedFel] Graduate Degree [/group]
[group MedFel] Year of Graduation —Please choose an option—20222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970 [/group]
[group NewMedFel] License State —Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinois IndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontana NebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvania Rhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming [/group]
[group NewMedFel] MD/DO License Number [/group]
[group NewMedFel] License Status —Please choose an option—ActiveRestrictedRetiredVoluntaryCharity CareN/A [/group]
[group NewMedFel] Specialty [/group]
[group NewMedFel] Board Certified —Please choose an option—YesNo [/group]
[group NewMedFel] Sub-Specialty [/group]
[group NewFel]
Email
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Fax
Appointment Phone
Preferred Contact Method —Please choose an option—PhoneEmail
[group Committee]
What committee(s) would you like to join? * Membership/MentorshipScholarshipFundraisingProgramming
[group Attestation]
Conditions of membership: Every person who seeks membership to Mary Susan Moore Medical Society of Houston (hereafter “MSMMS”) must be an MD, DO, DPM, or in training towards these degrees at the time of application and initial appointment and continuously thereafter, demonstrate: 1) ability to work and relate to other members, and members of other medical societies, organizations, visitors and medical community leaders and in general, in a cooperative, professional manner that is essential for maintaining an environment appropriate to quality and efficient medical action; 2) To be of high moral character and to adhere to generally recognized standards of professional ethics.
Regularly attend meetings, and be regularly involved in the activities of the society.
Vote on all matters presented at the general and special meetings of the society and committees, of which she is a member.
Hold office at any level in the society and to be chairperson of a committee, provided she satisfies the specific qualifications for the position involved.
Contribute to the organizational and administrative activities of the society, including service to the society and special functions and committees, faithfully performing the duties of any office or position to which elected or position to which appointed.
Participate equitably in the discharge of the society functions as reasonably assigned by the applicable committee chairperson or other authorized member.
[group MedFel]
Select a membership option and continue to payment.
Select an OptionMedical Student - $11Fellow/Resident - $26.50
[group Tiers]
$130
Annual Membership
Attract new patients through our online directory
Professional and personal support from other Black female physicians
Mentorship
Community Service
Professional enrichment
Select an OptionGold - $130
$260
MSMMS T-shirt (add link for T-shirt order)
Acknowledgement on website
Select an OptionPlatinum - $260
$520
Commemorative MSMMS plaque
Select an OptionVibranium - $520
You will be redirected to PayPal to complete your payment.
[group Submit]