a4m_membershipform_2011

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AMERICANACADEMY OFANTI-AGINGMEDICINE (A4M)

New Membership / Renewal Application Form

Name ..........................................

Degrees : [ ] DO MBBS DC DDS ND PhD RPh RN NP PA Other :Title

Practice/Company

Mailing Address

City, State, Zip

Country :

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I wish to be accepted as a member of the American Academy of Anti-Aging Medicine and agree to abide by its By Laws and Code of Ethic

Signed : Date :

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PAYMENT INFORMATIONYour membership will not be processed without full payment or if your credit card is declined.

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Name on CC :

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Signature : Date :

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[ ] Credit Card [ ] MC [ ] Visa [ ] AMEX

A4M,

MEMBERSHIP CATEGORYsraeY5sraeY2raeY1yrogetaCpihsrebmeM

00.005$00.052$)SBBM,OD,DM(pihsrebmeMnaicisyhP][

[ ] Scientific/Healthcare (DC, DDS, ND, DPM, R.Ph, PhD, RN, NP, PA

[ ] Preferred General Public $95.00 --

Oce Use Only

Membership #

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Acc Rep:__________

REMIT COMPLETED FORM TO:

Academy of Anti-Aging Medicine

Membership Department

_________________________

1510 West Montana StreetChicago, IL 60614 USAPhone:1-800-558-1267 ext 531Fax: 561-997-0287

Attn:

Tracking Group# : _____________________

An Organizational Membership affords you extended benefits.Contact the A4M Membership Department for details.

Allow 6-8 weeks for processing your new membership applicationand receipt of your Welcoming Kit and Member Certificate.

Applicants wishing to return their A4M membership are required tocomply to A4M.s

Membership Return Policy. Instructions are available on theMembership. page at www.worldhealth.net and from the A4M

Membership department.

For inquiries, contact Customer Services at: or [email protected]

$250.00 $500.00


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AccomplishmentsThe A4M's leadership position in the science of anti-aging medicine continues unsurpassed, and our accomplishments overthe past year include:

A4M's membership stands at 11,500 members from 90 countries, making the A4M both the premier medical societyconfronting the dilemmas of aging and the fastest-growing medical society in the world.

Seminars and physician training programs in venues in Japan, Spain, Singapore, Mexico, Brazil, and Belgium, as

well as New York City, Chicago, and Las Vegas have drawn participants from the most prestigious educational,government, and private institutions from across the world. Board Certification in Anti-Aging Medicine: The American Board of Anti-Aging and Regenerative Medicine

(ABAARM)was created to facilitate the recognition of this emerging medical specialty. To date, there are 400 MDsand DOs who are Board Certified or Diplomates. The American Board of Anti-Aging Health Practitioners (ABAAHP)enables Doctors of Chiropractic (DC), Doctors of Dentistry (DDS), Naturopathic Doctors (ND), Doctors of PodiatricMedicine (DPM), Registered Pharmacists (RPh), as well as scientists, to pursue certification. Since its firstadministration in December 1999, over 100 health practitioners have achieved Diplomate status.

Publications:o New Anti-Aging Secrets for Maximum Lifespan, with easy-to-use informative self-tests, checklists, and quizzes

sprinkled throughout and powerhouse Plans for Longevityo Anti-Aging Medical News, a quarterly newsletter reaching 50,000 international readerso Fifth textbook on anti-aging medicine, Anti-Aging Medical Therapeutics, vol 10

Distribution of research grants to Dr. Walter Pierpoli (Italy) and Oklahoma State University to support studies thatadvance anti-aging medicine

Expansion of the Internet's #1 anti-aging portal, www.worldhealth.net:o Supporting A4M's mission of promoting grass-roots advocacy and awareness of this new clinical science to

expand the potential patient baseo Now approaching upwards of 2 million visitors monthlyo On-line Physician's Referral Network, accommodating 350+ patient inquiries weeklyo Features weekly thought-provoking polls, longevity news, audio clips, and late-breaking announcements

from the A4M Through mailings and media exposure, the A4M continues its consumer education campaign, introducing millions of

people to anti-aging medicine and related scientific breakthroughs.

Applicants, please note: An Organizational Membership affords you extended benefits. Contact the A4M Membership Department for details. Allow 6-8 weeks for processing of your new membership application and receipt of your Welcoming Kit and

Member Certificate. If the applicant wishes to return their A4M membership, s/he is required to comply to A4M's Membership Return Policy.

Instructions are available at the "Membership" page at www.worldhealth.net and from the A4M Membership Dept.

For inquiries, contact A4M Membership Department, Tel: (800) 558-1267, Fax (561) 997-0287,or e-mail [email protected].

A4M Membership


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A4M Membership

What is the A4M Membership?As an all-volunteer medical society, the officers and directors of A4M receive no financial compensation for their tirelessefforts in developing and promoting the organization. Yet, the A4M remains committed to expanding the benefits of yourmembership. As of November 2008, we are pleased to announce member benefits that put your membership dollars to workfor you as well as the burgeoning clinical specialty of anti-aging medicine.

Member BenefitsBecoming a member of A4M gains you access to over a decade of established anti-aging expertise. Position yourself as beingthe first to learn of the latest breakthroughs in preventive and interventive techniques that help your patients achieve theirpersonal best in wellness, maximum longevity and a fulfilling quality of life.

Join now, increase your practice income and take advantage of the following membership benefits:

A4M Accreditation: A4M maintains the most recognized credentialing program for physicians, scientist, andhealthcare professionals.

Physician Generation Service: A4M fields approximately 350+ inquires monthly from the public, interested in

finding a qualified anti-aging medical specialist, groups and other services.

Anti-Aging Physicians and Health Practitioners Directory: Over 700 listings of physicians, searchable by name

and location

Anti-Aging Clinics and Spas Directory

Anti-Aging Products and Services Directory

American Board Certification Programs: A4M membership makes you eligible to take the written and oral exam to

become board certified. ABAARM offers medical professionals recognition of specialty knowledge and clinical

practice of anti-aging medical care.o The American Board of Anti-Aging and Regenerative Medicine (ABAARM) -

For PHYSICIAN MEMBERS ONLY - issues Board Certification to individuals with M.D. (Doctor of Medicine),D.O. (Doctor of Osteopathic Medicine), and M.B.B.S. (Bachelor of Medicine/Bachelor of Science) degrees.

o The American Board of Anti-Aging Health Practitioners (ABAAHP) - For SCIENTIFIC HEALTHCAREMEMBERS ONLY - issues Diplomate Certificate to Doctors of Chiropractic (DC), Doctors of Dentistry (DDS),Naturopathic Doctors (ND), Doctors of Podiatric Medicine (DPM), Registered Pharmacists (RPh), scientists(PhD and similar), Registered Nurses, Nurse Practitioners, and Physician Assistants.

Advertising Opportunities: Receive special discounts on print advertising, online advertising and conference boothsand reach out to your prospective customers.

Complimentary subscription to our award-winning journal: Anti-Aging Medical News: Anti-Aging Medical News:This trendsetting industry publication serves as a forum of exchange between physicians and professionals deliveringclinical healthcare, scientists, researchers, government and private institutions and commercial entities.

Discounts on all A4M-sponsored events: As members, you will receive special incentive DISCOUNTS (up to nearly

50% discounts on the actual on-site value of the registration). Discounts on A4M Educational Materials: Learn anti-aging from the organization that created the anti-aging specialty

with our library of. State-of-the-Science educational books, videos, tapes, and CDROMs. Complimentary Electronic Biotech Newsletters: E-Biotech Newsletter (EBN) is a service of the American Academy

of Anti-Aging Medicine, focused on clinical answers to aging related disorders leading to a longer andhealthier lifespan.

Exclusive Promotional Offers: Receive promotional offers/samples from hundreds of vendors before eachmedical conference

Discussion Forum Networking Opportunities Financial Incentives: Many members can save more than the actual cost of their annual membership dues through al

of our financial incentives.

Discounts on Professional Marketing Materials Complimentary subscription to A4M News


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Get ListedThe anti-aging directory is one of the most popular areas of our website. Our visitors are keen to learn about and experiencethe anti-aging lifestyle and practices they read about when visiting. A listing on our directory will put your practice, productor spa in front of an audience keen to live a healthy, anti-aging lifestyle living in your local area.

Examples of ListingsPremium listing positioning and advantages

With a Premium listing you can enjoy the following benefits in addition to those received with a Full listing:

Listing in the top section of research results. The listings will rotate daily so all entries can enjoy the same exposure

A bold and prominently highlighted listing

Improve the look of your listing and build your brand with an image or logo

Provide your potential customers with vital information about your product or service whist their interest is fresh

Full listing positioning and benefits

With a Full listing you will receive the following benefits in addition to those received with a basic* listing:

Feature above the basic* listings in search results. The listings will rotate daily so all entries can enjoy

the same exposure

A bold and highlighted listing

A direct link to your website

Receive enquiries from potential customers direct to your inbox with our contact form

* Basic listings are not available to purchase. They are only made available by A4M as part of selected promotionsor packages.

Directory Listing

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