International MYOPAIN Society [IMS]

Membership Application / Renewal [Page 1/4]

Name

Address

Contact Information

Health Professional Field Code

Select... 001 Biochemist 002 Biostatistician 003 Chiropractor 004 Dentist 005 Epidemiologist 006 Exercise Physiologist 007 Massage Therapist 008 Medical Anthropologist 009 Medical Educator 010 Medical Transcriptionist 011 Medical Biographer 012 Medical Librarian 013 Medical Economist 014 Medical Writer 015 Medical Products Business Person 016 Medical Instrumentation 017 Medical Computer Specialist 018 Medical Technologist 019 Microbiologist 020 Nurse, Nurse Practitioner 021 Occupational Therapist 022 Pharmaceutical Business Person 023 Pharmacist, Pharm D 024 Physical Therapist 025 Physician Assistant 026 Physician (MD, DO, Equivalent) 027 Physiologist 028 Polysomnographer 029 Psychologist 030 Research, Applied 031 Research, Clinical 032 Research, Basic 033 Social Worker 034 Support Group Leader 035 Other