Get Membership Application Form - Philippine Academy Of Ophthalmology - Pao Org

Completing the Membership Application Form for the Philippine Academy of Ophthalmology is a step towards joining a distinguished community of ophthalmologists. This guide provides a clear, step-by-step approach to ensure you fill out the form correctly and efficiently.

Follow the steps to successfully complete your application online.

1. Press the ‘Get Form’ button to access the Membership Application Form and open it in your selected editor.
2. Begin by specifying the type of membership you wish to apply for: either Associate (Non-Diplomate) or Member (Diplomate). Clearly mark your choice.
3. In the next section, provide your personal information. Fill in your name, including your last name, first name, and middle initial. Indicate your sex and enter your birthdate and birthplace.
4. List your educational background. State the name of your medical school and the year you graduated. Follow up with the name of your residency institution and the year completed.
5. Indicate if you are PBO certified by checking 'Yes' or 'No.' If 'Yes,' provide the date of certification.
6. Fill in your Professional Regulation Commission (PRC) number and Philippine Medical Association (PMA) number.
7. Provide your residence address, email address, telephone, and mobile phone number. Include your fax number if applicable.
8. Upload a recent 2” x 2” photo as per the form's requirements.
9. If your mailing address differs from your residence, complete the additional mailing address section.
10. Fill in the main (primary) clinic address and telephone number, followed by details of any other clinics you are affiliated with.
11. List all your hospital affiliations, both private and government.
12. Indicate your main and secondary geographic areas of practice by providing the relevant town/city, province, and region.
13. Select your subspecialty from the available options provided in the form. If your subspecialty is not listed, you may specify it.
14. Complete the statements of endorsement section by gathering the necessary signatures from department chairpersons and members of the Philippine Academy of Ophthalmology, along with their details.
15. Read the applicant certification statement thoroughly. By signing here, you acknowledge all information provided is accurate and complete.
16. Indicate your payment method and provide the relevant details, including cash, check, or credit card information.
17. Once you've completed all sections, carefully review the form for accuracy. Then, save your changes, and proceed to download, print, or share your completed application form.

Take the next step toward membership by completing your application online today.