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You are here: Home / For Health Care Providers / Become a Member

Become a Member

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American Physicians Network (APN) Membership is a mark of distinction within the international medical community. There is no cost to join APN, and APN Members pay no dues or referral fees for participation in the APN network. For our patient clients, APN Membership is an assurance of quality and excellence.

To be considered for APN Membership, you may start the process by completing the form below, including Cover Letter, CV, Professional Photo, Board Certification & Licensure, and Proof of Surgical Privileges. All materials must be submitted, along with a certification that the information is true and accurate, before the review process begins.

If you have questions or would like additional information about APN’s exclusive network of providers, please contact us online.

APN Membership Application Form

Fields marked with * are required.

    First Name or Given Name *

    Middle Name

    Last Name or Surname *

    Degree *

    Email Address *

    Mobile Telephone Number *

    Work Telephone Number

    Specialty / Sub-Specialty

    Practice or Group Name

    Country *

    Cover Letter *

    Your Cover Letter must include a brief introduction, statement about your experience and areas of specialty focus, and explain why you would like to join APN.

    (Max Size 2 MB - .pdf, .doc, .docx, .odt, .txt)

    Curriculum Vitae (CV) *

    Your CV must include your Full Legal Name, Date of Birth, Contact Information (including physical address. mailing addresses, email address, and telephone numbers), Education History (including description of program length as well as any specialty or fellowship training courses), Work History, Hospital Affiliations (including hospital address and contact information), Professional Memberships, Professional Appointments, Publications, and at least three Professional References.

    (Max Size 2 MB - .pdf, .doc, .docx, .odt, .txt)

    Professional Photo (Head Shot) *

    Your Professional Photo must include a picture of you that shows your head and shoulders.

    (Max Size 2 MB - .pdf, .jpg, .tiff, .tiff, .png, .gif)

    Medical Degree, Board Certification & Active Medical Licensure *

    Your document must include information on your Medical Degree, current Board Certification, and active Medical Licensure in your medical or surgical specialty. Any documentation you submit is subject to verification.

    (Max Size 2 MB - .pdf, .doc, .docx, .odt)

    Proof of Hospital and/or Surgical Privileges *

    Your document must include information on your active Hospital and/or Surgical Privileges at a Joint Commission International approved facility. Any documentation you submit is subject to verification.

    (Max Size 2 MB - .pdf, .doc, .docx, .odt)

    I hereby certify that all information contained in my application is true and correct to the best of my knowledge, and I consent to a criminal background check.

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