Membership Registration

CPAA Membership Registration
FREE to all DCs!!!
Voluntary dues are welcome, to help with cause

No registration information will be sold, given out or distributed

Email: *

Just curious from which school did you graduate?

Comments:

Payment Button

Out State Voluntary dues payment,

please click bellow for payment

Office Phone:

Cell Phone:

City: *

Last Name: *

Thank you for your registration. You will receive your membership certificate at the end of the day, except on weekend and holidays. To register as an FCPA member please visit our website at http://www.myfcpa.org/registration-payment2.html

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Chiropractic Physician Association of America Inc.

Do you hold any chiropractic office? *

Yes

I am *

LMT

CCPA

CPA

Retired

Student

I have attended an FCPA Seminar in the past *

Yes

Fax:

How did you hear about us? *

By email

Referred by a friend

Magazined ad

Phone call From FCPA

Postcard

Zip Code: *

First Name: *

Are you interested in getting involved in advancing our laws? *

Yes

License #: *

If you do what office do you hold?

Do you agree Chiropractors should have Prescription Privileges? *

Yes

Undecided

State: *

Address: *

Date of Birth: *

I am a member of the FCPA *

Yes

(Seminar Registration)

If you are interested in registering for and/or paying for one of our CE Seminars please click here.

To make it easier for us when you click to register for a seminar you will be taken to the Florida Chiropractic Physician Association (FCPA) Registration page.

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