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Membership Type: Chiropractic Physician Neurosurgeon

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$250 (1 Year Membership)
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I, the undersigned, hereby make voluntary application to the American Academy of Spine Physicians (AASP). I understand and agree that in making application to, and/or being accepted as a member of the AASP, that I am a licensed neurosurgeon or chiropractic physician and that my professional practice as such involves the evaluation and care of patients with spinal disorders.

I further agree that I will honor and comply with all local, state and federal laws and regulations which apply to me as a person and as a professional, and that I will conduct myself in a manner consistent with the highest level of professional ethics. I agree to be bound by the ethical statutes of the AASP found in the AASP Documentation Library.

I affirm that the information that I have provided to the AASP is true and accurate. I agree to function within the limits of my training, competence, and professional license. I further understand and agree that the AASP and its affiliates assume no responsibility for any of my activities or actions.

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Fax Application to : (847) 931-7975

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American Academy of Spine Physicians
1795 Grandstand Place
Elgin, Illinois 60123-4980