Membership Application

This form will take approximately 5-10 minutes to complete

Please have the following documents/information readily available:

  1. Info item one
  2. Info item two
  3. Info item three

Application Number: 123456

= Required = Optional

Academic Training
Psychiatry Residency Training

And other medical specialty training, including fellowship programs; list the most recent training first and include copies of training certificates. The APA does not capture additional training outside of psychiatry unless it is a combination (i.e. Family Practice/Psychiatry; Internal Medicine/Psychiatry or Pediatric/Psychiatry) residency training program due to space limitations of the database.

Add more Residency Training

Does the preceding training information reflect recognized completion of residency training in psychiatry approved by the Residency Review Committee for Psychiatry of the Accreditation Council for Graduate Medical Education, the Royal College of Physicians and Surgeons of Canada, or the American Osteopathic Association?
Board Certifications

Add another Board Certification

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