JOIN LCMS
LCMS Application
LEE COUNTY MEDICAL SOCIETY, INC.
MEMBERSHIP APPLICATION AND INFORMATION
P. O. Box 60041 Fort Myers, FL 33906-0041
Above is a link for a Lee County Medical Society application. Please complete and return to the Medical Society office for processing.
Please be sure when filling out your application that you include all addresses of your practice in Lee County and not your present address outside of Lee County. Addresses must be complete for physician references, association references, medical schools, internships, residencies and other hospital affiliations. Zip codes are needed. By including the above you will speed up the application process.
Pictures:
We will need a professional photo taken within the past year. The
photo will be used for the LCMS Pictorial Directory, Bulletin, and
website. You may mail a photo with your application or email a jpeg
or tif file to the Lee County Medical Society Office.
References:
Once your application has been received your references will be
checked. Please allow enough time by sending us your application
as soon as possible. Please use only references of your peers (M.D.'s
or D.O.'s). Do not use relatives, non-physicians or references in
Lee County*. The Society reserves the
right to contact anyone who might have an opinion concerning your
qualifications. In addition to your application and three photographs,
a copy of your Florida Medical License is required. Your continuing
Medical Education number from the American Medical Association is
required for dues processing. If you do not have this number leave
it blank and we will contact the AMA. After favorable action by
the Committee on Ethical and Judicial Affairs (EJA) and Board of
Governors, your application will be presented to the Membership
for their final approval. It is important that you or your office
make appointments to interview with two members of the Committee
on Ethical and Judicial Affairs (In person or over the phone).
2009 President and
EJA Chair
LARRY HOBBS, M.D., PRESIDENT (239) 939-8611
AUDREY FARAHMAND, M.D., CHAIR, EJA (239) 332-2388
Should you have any questions, please contact the Medical Society office. We will be glad to assist you. Ann Wilke, Executive Director Lee County Medical Society, Inc. Telephone (239) 936-1645
*EXCEPTION: A physician
practicing in the Lee County area for MORE THAN FIVE YEARS does
not have to provide out of town references, but may use four medical
references from the Lee County area or outside of Lee County. Two
references in Lee County must be Lee County Medical Society members
and no more than two references can come from the applicant's immediate
practice.
